Individual
MRS. MARY KATHERINE KAUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
13133 N PORT WASHINGTON RD, SUITE 122, MEQUON, WI 53097-2419
(262) 243-3700
(262) 243-3701
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(262) 243-3700
(262) 243-3701
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
3526-33
WI
Other
Enumeration date
12/09/2008
Last updated
10/31/2011
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