Individual provider Active NPI

Kristin Anne Haglund, PHD, APRN

  • Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1972640068
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
573-33 Issued in WI
Practice address
5433 W Fond Du Lac Ave
Milwaukee, WI 53216-1382
Phone
(414) 277-8900
Fax
(414) 277-8939
NPI assigned
Jan 30, 2007
Last updated
Jul 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 573-33 WI
Pediatric Nurse Practitioner 363LP0200X 573-33 WI
Registered Nurse 163W00000X 105391-030 WI
Nurse Practitioner 363L00000X 573-33 WI Primary

Addresses

Primary practice location

5433 W Fond Du Lac Ave
Milwaukee, WI 53216-1382

Mailing address

5433 W Fond Du Lac Ave
Milwaukee, WI 53216-1382
Phone (414) 277-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070710000614 WI Practitioner - Nurse Practitioner 1557461209 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
105391-030WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 15, 2013 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients
The Medical College of Wisconsin, Inc. Current Accepting new patients
Childrens Medical Group Inc CurrentSince Jul 1, 2013 Accepting new patients
Marquette University Past Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

11035 W Forest Home Ave
Hales Corners, WI 53130
Phone (414) 425-5660

5433 W Fond du Lac Ave
Milwaukee, WI 53216
Phone (414) 277-8900

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Interoperability endpoints

  • Direct secure messaging: khaglundapnp142678@direct.froedtert.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1972640068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5433 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161382",
            "telephone_number": "414-277-8900",
            "fax_number": "414-277-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5433 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161382",
            "telephone_number": "414-277-8900",
            "fax_number": "414-277-8939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGLUND",
        "first_name": "KRISTIN",
        "middle_name": "ANNE",
        "credential": "PHD, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "573-33",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "573-33",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "105391-030",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "573-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.