Individual
KARA J. ENERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
710 RIVERSIDE DR, WAUPACA, WI 54981-1941
(715) 256-3000
(715) 256-3079
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3200
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1370
WI
363AS0400X
Surgical Physician Assistant
1370
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34412200
—
WI
Enumeration date
04/04/2007
Last updated
08/09/2016
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