Individual
KATHERINE O'CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2000
Mailing address
1311 VIEW LN, GREEN BAY, WI 54313-5688
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7994
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100294017
—
WI
Enumeration date
04/10/2023
Last updated
11/05/2024
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