Provider Demographics
NPI:1174596795
Name:LAPOW, CARRIE L (APNP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:L
Last Name:LAPOW
Suffix:
Gender:F
Credentials:APNP
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:N17 W24100 RIVERWOOD DRIVE SUITE 250
Mailing Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES INC
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1177
Mailing Address - Country:US
Mailing Address - Phone:262-928-4100
Mailing Address - Fax:262-928-5835
Practice Address - Street 1:S69 W15636 JANESVILLE ROAD
Practice Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150
Practice Address - Country:US
Practice Address - Phone:262-928-7000
Practice Address - Fax:414-422-2075
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2024-12-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI112622363L00000X
WI2303363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41178200Medicaid
WIQ019240001Medicare UPIN
WI002568004Medicare PIN
WI683750681Medicare PIN