Individual
KATIE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9000 W WISCONSIN AVENUE, DIVISION OF PEDIATRIC NEPHROLOGY, MILWAUKEE, WI 53226-4874
(414) 337-7140
(414) 337-7145
Mailing address
9000 W WISCONSIN AVENUE, DIVISION OF PEDIATRIC NEPHROLOGY, MILWAUKEE, WI 53226-4874
(414) 337-7140
(414) 337-7145
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
82149
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730715830
—
WI
Enumeration date
03/20/2020
Last updated
09/01/2023
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