Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 9212-33 | WI |
NPI | 1023674983 |
---|---|
Provider Name | Kaitlyn Solveson |
First Address | Waukesha, WI 53188-6906 |
Second Address | Waukesha, WI 53188-6906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2019 |
Last Update Date | 16/05/2019 |