Individual
KATHLENE A KUSIV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1537 PARK PL STE 200, GREEN BAY, WI 54304-1974
(920) 498-8650
(920) 498-0945
Mailing address
1537 PARK PL STE 200, GREEN BAY, WI 54304-1974
(920) 498-8650
(920) 498-0945
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
33267-021
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31862800
—
WI
01
—
33287
WIS LICENSE
WI
Enumeration date
08/05/2006
Last updated
11/02/2010
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