Provider Demographics
NPI:1932944519
Name:KALKOFEN, ALLY ELIZABETH (APNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:ALLY
Middle Name:ELIZABETH
Last Name:KALKOFEN
Suffix:
Gender:F
Credentials:APNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 MEMORIAL DR APT 212
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-1294
Mailing Address - Country:US
Mailing Address - Phone:715-548-9158
Mailing Address - Fax:
Practice Address - Street 1:933 WAUBE LN
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-5521
Practice Address - Country:US
Practice Address - Phone:920-548-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1551433363LC1500X
WI15514-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health