Provider Demographics
NPI:1649905381
Name:KAISER, ANDREA (PMHNP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:KAISER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MINERAL POINT
Mailing Address - State:WI
Mailing Address - Zip Code:53565-1287
Mailing Address - Country:US
Mailing Address - Phone:608-708-5279
Mailing Address - Fax:608-305-8956
Practice Address - Street 1:122 HIGH ST
Practice Address - Street 2:
Practice Address - City:MINERAL POINT
Practice Address - State:WI
Practice Address - Zip Code:53565-1287
Practice Address - Country:US
Practice Address - Phone:608-708-5279
Practice Address - Fax:608-305-8956
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG169686363LP0808X
WI13023363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health