Individual
KATIE BOERST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
W5282 AMY AVE, APPLETON, WI 54915-7233
(920) 358-1900
Mailing address
414 W 5TH ST, APPLETON, WI 54911-6006
(920) 764-0132
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
220741-30
WI
363LF0000X
Family Nurse Practitioner
Primary
13024-33
WI
Other
Enumeration date
05/11/2022
Last updated
08/02/2022
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