Individual
KAITLYN MARK MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8710
(414) 955-0115
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8710
(414) 955-0115
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
4827
WI
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285294173
—
WI
Enumeration date
06/13/2019
Last updated
03/03/2025
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