Individual
KATHRINE E PEDRIANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2906 S 20TH ST, MILWAUKEE, WI 53215-3732
(414) 672-1353
(414) 672-0191
Mailing address
PO BOX 778789, CHICAGO, IL 60677-8789
(414) 672-1353
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004672
WI
363AM0700X
Medical Physician Assistant
PA10004672
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0188183
L & I
WA
01
—
6684PE
REGENCE
WA
01
—
8405490
CHPW
WA
05
—
8405490
—
WA
01
—
8937049
CRIME VICTIMS
WA
01
—
911019392
COMMERCIAL
—
Enumeration date
10/05/2006
Last updated
06/26/2023
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