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NPI Code Detail

MEDICARE: MRS. MICHELLE KIEFER OTR

MEDICARE: MRS. MICHELLE KIEFER OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist5051-026WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144658592
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE KIEFER OTR
Provider Business Mailing Address
First Line : N25W27115 ORCHARD LN
Second Line :
City : PEWAUKEE
State : WI
Zip : 53072-4952
Country : US
Telephone Number : 262-347-5575
Fax Number :
Provider Business Practice Location Address
First Line : 9806 W LINCOLN AVE
Second Line :
City : WEST ALLIS
State : WI
Zip : 53227-2234
Country : US
Telephone Number : 414-543-5330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2013
Last Update Date : 03/17/2018

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Directions to “ MRS. MICHELLE KIEFER OTR” Practice Location

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