Individual
KRISTIN J WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3605 STEWART AVE, WAUSAU, WI 54401
(715) 847-0800
Mailing address
203 N EMERALD DR, WAUSAU, WI 54401-3969
(715) 571-0865
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38116
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32345300
—
WI
Enumeration date
08/31/2006
Last updated
09/12/2023
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