Individual
KATIE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 SMITH AVE, OCONTO, WI 54153-1010
(920) 834-7600
(920) 834-7601
Mailing address
8405 COUNTY ROAD CC, OCONTO FALLS, WI 54154-9506
(920) 373-4657
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8316
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100078233
—
WI
Enumeration date
03/29/2018
Last updated
12/01/2021
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