Individual
KATIE MARIE OMERNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2031 PEACH ST, WISCONSIN RAPIDS, WI 54494-5181
(715) 423-0122
Mailing address
2031 PEACH ST, WISCONSIN RAPIDS, WI 54494-5181
(715) 423-0122
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7916-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083132526
—
WI
Enumeration date
09/05/2017
Last updated
12/20/2018
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