Individual
KATHRYN L SPORS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP
Contact information
Practice address
1225 REMMEL DR, JOHNSON CREEK, WI 53094-8511
(920) 674-6255
(920) 674-5288
Mailing address
147 W ROCKWELL ST, JEFFERSON, WI 53549-2048
(920) 674-6255
(920) 674-5288
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
161498-30
WI
363LF0000X
Family Nurse Practitioner
Primary
5367-33
WI
Other
Enumeration date
07/18/2013
Last updated
04/06/2020
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