Individual
MRS. KATIE JANE BALDERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY STE 1080, MILWAUKEE, WI 53215-3689
(414) 908-6506
(414) 908-6510
Mailing address
1033 N MAYFAIR RD STE 101, WAUWATOSA, WI 53226-3442
(414) 454-0600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3253-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3253-23
STATE LICENSE
WI
Enumeration date
11/02/2013
Last updated
01/26/2026
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