Individual
KATELYN RENEE KOPACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP, FNP-BC
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-7400
(414) 805-7388
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-7400
(414) 805-7388
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
15617
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144068677
—
WI
Enumeration date
07/18/2024
Last updated
08/08/2024
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