Provider Demographics
NPI:1750460994
Name:ROHOWETZ, LAURA B (CPNP)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:B
Last Name:ROHOWETZ
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:B
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:9000 W WISCONSIN AVE # MS 666
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-3535
Mailing Address - Fax:
Practice Address - Street 1:9000 W WISCONSIN AVE # MS 666
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-3535
Practice Address - Fax:414-266-1657
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI141353363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1750460994Medicaid
WI68086 1154Medicare PIN
WI73601 2365Medicare PIN