Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 38174 | WI |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 38174 | WI |
NPI | 1447223037 |
---|---|
Provider Name | Katherine R. Stevenson |
First Address | Waukesha, WI 53188-5031 |
Second Address | Waukesha, WI 53188-5031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 02/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32283900 | (05) | WI |
E92272 | (02) | WI |