Individual
KATY ELLINGSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
W129N7055 NORTHFIELD DR, MENOMONEE FALLS, WI 53051-0538
(262) 253-5400
Mailing address
W129N7055 NORTHFIELD DR, MENOMONEE FALLS, WI 53051-0538
(262) 253-5400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2190-23
WI
363A00000X
Physician Assistant
NOT YET ISSUED
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033005090
MEDICARE
—
05
—
41946400
—
WI
Enumeration date
07/24/2007
Last updated
01/30/2026
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