Provider Demographics
NPI:1588081913
Name:O'LOUGHLIN, LAURA W (APNP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:W
Last Name:O'LOUGHLIN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W LAYTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53221-5434
Mailing Address - Country:US
Mailing Address - Phone:262-297-7246
Mailing Address - Fax:888-714-0578
Practice Address - Street 1:2500 W LAYTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53221-5434
Practice Address - Country:US
Practice Address - Phone:262-297-7246
Practice Address - Fax:888-714-0578
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-24
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5641363L00000X
WI5641-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner