Healthcare Provider Details

I. General information

NPI: 1114139409
Provider Name (Legal Business Name): KEIRSEN MUFFLER MA, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 N LAKE DR SUITE 1005
MILWAUKEE WI
53211-4518
US

IV. Provider business mailing address

13205 W CLEVELAND AVE
NEW BERLIN WI
53151-3901
US

V. Phone/Fax

Practice location:
  • Phone: 414-271-4141
  • Fax: 414-271-4343
Mailing address:
  • Phone: 262-785-1160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number283-156
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number283-156
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: