Individual
KATHERINE A MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(920) 288-5500
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11859
WI
363LP0200X
Pediatric Nurse Practitioner
11859
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100197905
—
WI
Enumeration date
03/01/2022
Last updated
04/14/2025
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