Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 209.008006 | IL |
NPI | 1174834154 |
---|---|
Provider Name | Katharine Elaine Davis Hart |
First Address | Wauwatosa, WI 53226-4874 |
Second Address | Wauwatosa, WI 53226-4874 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2010 |
Last Update Date | 24/06/2010 |