Provider Demographics
NPI:1508973132
Name:WESLING, KIM C (NP)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:C
Last Name:WESLING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 E MASON ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-3813
Mailing Address - Country:US
Mailing Address - Phone:414-665-8400
Mailing Address - Fax:414-665-5730
Practice Address - Street 1:633 E MASON ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-3813
Practice Address - Country:US
Practice Address - Phone:414-665-8400
Practice Address - Fax:414-665-5730
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI500-033,99889-030363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43943500Medicaid
WI43943500Medicaid