| Jeremy L Kaup, PMHNP | |
|
3224 Kennsington Square Rd, Sturtevant, WI 53177-2821 | |
| (262) 762-9284 | |
| (262) 419-3818 |
| Full Name | Jeremy L Kaup |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 3224 Kennsington Square Rd, Sturtevant, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649970773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 13690-33 (Wisconsin) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 13690-33 (Wisconsin) | Primary |
| Entity Name | Ascension Medical Group-southeast Wisconsin Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609881077 PECOS PAC ID: 8628980943 Enrollment ID: O20031104000421 |
| Entity Name | Professional Services Group Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619024262 PECOS PAC ID: 8224296454 Enrollment ID: O20120220000742 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremy L Kaup, PMHNP 212 4th St, Racine, WI 53403-1005 Ph: (262) 206-0412 | Jeremy L Kaup, PMHNP 3224 Kennsington Square Rd, Sturtevant, WI 53177-2821 Ph: (262) 762-9284 |
Michelle Lynne Guidry, APRFNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 717 S Sylvania Ave, Sturtevant, WI 53177 Phone: 262-898-8491 Fax: 262-898-8492 | |
Jeanie Marie Kramer I, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2019 Wisconsin St, Sturtevant, WI 53177 Phone: 608-249-9931 | |
Jordan Jon Stensgard, MSN, APNP, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8311 16th St, Sturtevant, WI 53177 Phone: 262-260-3671 Fax: 262-260-5013 |