Individual
KATAYONSADAT TABATABAEI DAKHILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
130 W BRUCE ST, #200, MILWAUKEE, WI 53204-1667
(414) 384-1400
Mailing address
130 W BRUCE ST, #200, MILWAUKEE, WI 53204-1667
(414) 384-1400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5171
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100027445
—
WI
Enumeration date
12/19/2012
Last updated
11/29/2021
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