Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 156726 | CA |
Y | 207VE0102X | Reproductive Endocrinologist | 73290 | WI |
NPI | 1558672170 |
---|---|
Provider Name | Katherine A. Green |
First Address | Milwaukee, WI 53215-2843 |
Second Address | Green Bay, WI 54311-6519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2010 |
Last Update Date | 22/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100101312 | (05) | WI |