Individual
KATELYN VANA HAASCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2000 E LAYTON AVE, ST FRANCIS, WI 53235-6053
(414) 744-7880
(414) 294-4570
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7659
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100262861
—
WI
Enumeration date
08/10/2023
Last updated
01/25/2024
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