| Organization Name: | URO GYN CONSULTATIONS LLC |
| NPI Number: | 1083051163 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KELLY KRUSE (OWNER) |
| Mailing Address: | 25951 Circle View Dr Richland Center |
| State: | WI US |
| Postal Code: | 535814013 |
| Phone Number: | 6086472138 |
| Fax Number: | |
| NPI Enumeration Date: | 05/29/2013 |
| NPI Last Update Date: | 05/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WU0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Urology |
| Taxonomy Definition: | |