Individual
KATHRYN BRUCATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 CHAPMAN FARMS BLVD, MUKWONAGO, WI 53149-8877
(262) 363-6160
Mailing address
120 CHAPMAN FARMS BLVD, MUKWONAGO, WI 53149-8877
(262) 363-6160
(262) 363-6165
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
235153-30
WI
363L00000X
Nurse Practitioner
Primary
22356
WI
363LP2300X
Primary Care Nurse Practitioner
22356-875
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100208921
—
WI
Enumeration date
09/15/2021
Last updated
11/16/2022
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