MEDICARE: LYNN B KOHLMEIER M.D.

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
1	208000000X	Pediatrics Physician	31381	WI

Other Identifiers

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

General Provider Information

NPI Number	:	1528053626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN B KOHLMEIER M.D.

Provider Business Mailing Address
First Line	:	849 WHISPER FALLS LN
Second Line	:
City	:	MENASHA
State	:	WI
Zip	:	54952-9503
Country	:	US
Telephone Number	:	262-227-0194
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 2ND ST
Second Line	:
City	:	NEENAH
State	:	WI
Zip	:	54956-2883
Country	:	US
Telephone Number	:	920-969-7906
Fax Number	:	920-969-7979

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	03/30/2023

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