Mrs. Mary Katherine Kautz
Nurse Practitioner - Gerontology
13133 N Port Washington Rd Suite 122
Mequon
, Wisconsin 53097-2419
Mrs. Mary Katherine Kautz
Nurse Practitioner - Gerontology
13133 N Port Washington Rd Suite 122
Mequon
, Wisconsin 53097-2419
(262) 243-3701
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Mrs. Mary Katherine Kautz
- 4425 N Port Washington Rd Attn: Csmcp Clinic Credentialing
- Glendale, WI
- Zip : 53212-1082
- Fax : (262) 243-3701
- Phone : (262) 243-3700
Second Address
- Mrs. Mary Katherine Kautz
- 13133 N Port Washington Rd Suite 122
- Mequon, WI
- Zip : 53097-2419
- Fax : (262) 243-3701
- Phone : (262) 243-3700
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 3526-33 | WI |
National Provider Identifier
| NPI | 1013152743 |
|---|---|
| Provider Name | Mrs. Mary Katherine Kautz |
| First Address | Glendale, WI 53212-1082 |
| Second Address | Mequon, WI 53097-2419 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/12/2008 |
| Last Update Date | 31/10/2011 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.