Healthcare Provider Details

I. General information

NPI: 1447165501
Provider Name (Legal Business Name): KARA ANDRE BSN, RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 LAWRENCE DR
DE PERE WI
54115-9108
US

IV. Provider business mailing address

N4364 COUNTY ROAD C
PULASKI WI
54162-7616
US

V. Phone/Fax

Practice location:
  • Phone: 920-605-3115
  • Fax:
Mailing address:
  • Phone: 920-619-4330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-312023
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: