Individual
DR. MARY K GATZKE
Active
Individual
DR. MARY K GATZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2426033
WI
363L00000X
Nurse Practitioner
4704241650
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
2426-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43999100
—
WI
01
—
N97840001
MEDICAID
MI
01
—
P00124270
RR - MEDICARE
WI
Enumeration date
09/30/2005
Last updated
04/06/2021
Update your record
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