Healthcare Provider Details

I. General information

NPI: 1396823191
Provider Name (Legal Business Name): LAURA L. MINIKEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/25/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 WATERTOWN PLANK RD
MILWAUKEE WI
53226-3548
US

IV. Provider business mailing address

945 N 122TH ST
MILWAUKEE WI
53233
US

V. Phone/Fax

Practice location:
  • Phone: 414-955-0728
  • Fax:
Mailing address:
  • Phone: 414-219-7370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA69731
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License NumberA69731
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number83511-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: