Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lakeside Family Practice

Organization Family Nurse Practitioner · NPI 1831698430

Lakeside Family Practice is a Family Nurse Practitioner in Kenosha, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2018.

Licensed in
WI
In the registry since
2018
Specialties on file
2

Practice location Address checks out

3200 Sheridan Rd Ste 104
Kenosha, WI 53140-1921
Phone: (262) 225-1014
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2011006054 (WI)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 6190-33 (WI)

Record details

NPI number1831698430
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Anthony Hale — Owner · (262) 225-1014
NPI enumeratedFebruary 8, 2018
Last updated in NPPESFebruary 8, 2018
Mailing address2113 Tallgrass Cir, Waukesha, WI 53188-2606

Other providers in Kenosha