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NPI Code Detail

MEDICARE: CORY SIEBURG NP

MEDICARE: CORY SIEBURG NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner6732WI

General Provider Information

NPI Number : 1396119806
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORY SIEBURG NP
Provider Business Mailing Address
First Line : 7974 UW HEALTH CT
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 HIGHLAND AVE
Second Line :
City : MADISON
State : WI
Zip : 53792-0001
Country : US
Telephone Number : 999-999-9999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2015
Last Update Date : 05/13/2026

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