Provider Demographics
NPI:1275418626
Name:VIRNIG, KIRSTEN MARIE (LMT)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:MARIE
Last Name:VIRNIG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N66W13559 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-6059
Mailing Address - Country:US
Mailing Address - Phone:414-531-6298
Mailing Address - Fax:
Practice Address - Street 1:N64W24050 MAIN ST STE 306B
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-3000
Practice Address - Country:US
Practice Address - Phone:262-200-1804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10073-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty