Healthcare Provider Details

I. General information

NPI: 1831008804
Provider Name (Legal Business Name): KRISTIN THIMMIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

800 MARSHAL CT
WEST BEND WI
53090-2128
US

V. Phone/Fax

Practice location:
  • Phone: 414-955-5591
  • Fax: 414-805-3999
Mailing address:
  • Phone: 414-955-5591
  • Fax: 414-805-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18664-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: