Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 196487-30 | WI |
NPI | 1003364811 |
---|---|
Provider Name | Kaitlin Schaeren |
First Address | Milwaukee, WI 53216-1382 |
Second Address | Milwaukee, WI 53216-1382 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2016 |
Last Update Date | 19/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003364811 | (05) | WI |