Individual
KATHRYN K HAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
(414) 329-5634
Mailing address
9702 N VALLEY HILL DR, MEQUON, WI 53092-5341
(262) 241-1853
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28628
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31363900
—
WI
Enumeration date
07/18/2006
Last updated
07/08/2007
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