Individual
MRS. KATHERINE MARIE BROCKWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1185 CORPORATE CENTER DR, OCONOMOWOC, WI 53066-4887
(262) 928-8400
Mailing address
1598 GHOST RIDER WAY, OCONOMOWOC, WI 53066-5722
(262) 237-1345
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
221523-30
WI
363L00000X
Nurse Practitioner
16470-33
WI
363LF0000X
Family Nurse Practitioner
Primary
16470
WI
Other
Enumeration date
02/07/2025
Last updated
03/14/2025
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