Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 2381 | WI |
NPI | 1306837984 |
---|---|
Provider Name | Catherine M Caspary |
First Address | Fond Du Lac, WI 54935-4560 |
Second Address | Fond Du Lac, WI 54935-4560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
14145 | DEAN (01) | WI |
41192000 | (05) | WI |
800536 | TOUCHPOINT (01) | WI |
P00172658 | RAILROAD MEDICARE (01) | WI |
Q19637 | (02) |