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NPI Code Detail

MEDICARE: LAUREN ETZKORN MD

MEDICARE: LAUREN ETZKORN MD
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1851193080
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN ETZKORN MD
Provider Business Mailing Address
First Line : 5000 W CHAMBERS ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53210-1650
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5000 W CHAMBERS ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53210-1650
Country : US
Telephone Number : 414-527-8191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2025
Last Update Date : 04/09/2026

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Directions to “ LAUREN ETZKORN MD” Practice Location

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