Provider Demographics
NPI:1013920297
Name:VOLKMAN, KRISTEN (MD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:VOLKMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 75TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-8213
Mailing Address - Country:US
Mailing Address - Phone:262-653-2260
Mailing Address - Fax:
Practice Address - Street 1:8500 75TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-8213
Practice Address - Country:US
Practice Address - Phone:262-653-2260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI457612080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1013920297Medicaid
WI391264986OtherTAX ID
WI736011704Medicare PIN
WI320640136Medicare PIN
WI680860633Medicare PIN