Individual
KATHLEEN MARIE ELERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 COUNTY ROAD B, SHAWANO, WI 54166-7072
(715) 524-2161
Mailing address
4939 MORNING GLORY DR, WEST BEND, WI 53095-8758
(262) 305-2917
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3598-033
WI
Other
Enumeration date
02/12/2016
Last updated
12/02/2021
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