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NPI Code Detail

MEDICARE: MRS. LAURA W O'LOUGHLIN APNP

MEDICARE: MRS. LAURA W O'LOUGHLIN APNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner5641-33WI
2363L00000XNurse Practitioner5641WI

General Provider Information

NPI Number : 1588081913
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA W O'LOUGHLIN APNP
Provider Business Mailing Address
First Line : 2675 N MAYFAIR RD STE 400
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-1305
Country : US
Telephone Number : 414-763-6910
Fax Number : 414-763-6911
Provider Business Practice Location Address
First Line : 2311 N PROSPECT AVE
Second Line : PROSPECT MEDICAL COMMONS
City : MILWAUKEE
State : WI
Zip : 53211-4445
Country : US
Telephone Number : 414-319-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2014
Last Update Date : 01/08/2026

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