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Individual
KATHRYN JANE BUTKOVICH
Active
Individual
KATHRYN JANE BUTKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
193019-30
WI
363LP0200X
Pediatric Nurse Practitioner
Primary
6620
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740665389
—
WI
Enumeration date
07/24/2015
Last updated
08/29/2019
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