Healthcare Provider Details

I. General information

NPI: 1801703988
Provider Name (Legal Business Name): KRISTIN MAE FUERSTENBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 N SHERMAN BLVD
MILWAUKEE WI
53210-2949
US

IV. Provider business mailing address

N172W20133 WOODLAND TRL
JACKSON WI
53037-9388
US

V. Phone/Fax

Practice location:
  • Phone: 414-875-5900
  • Fax:
Mailing address:
  • Phone: 262-573-5282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: