Provider Demographics
NPI:1770278624
Name:BYRNE, KATHLEEN RENEE (LPN)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:RENEE
Last Name:BYRNE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:RENEE
Other - Last Name:CALMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:606 ROHDA DR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53185-4222
Mailing Address - Country:US
Mailing Address - Phone:262-729-7997
Mailing Address - Fax:
Practice Address - Street 1:606 ROHDA DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:WI
Practice Address - Zip Code:53185-4222
Practice Address - Country:US
Practice Address - Phone:262-729-7997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI318006164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse