Healthcare Provider Details

I. General information

NPI: 1285528588
Provider Name (Legal Business Name): KATIE ELIZABETH PAFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE ELIZABETH KALTENBACH

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W NATIONAL AVE
MILWAUKEE WI
53295-0001
US

IV. Provider business mailing address

W264S8180 OAKDALE DR
MUKWONAGO WI
53149-8562
US

V. Phone/Fax

Practice location:
  • Phone: 414-384-2000
  • Fax:
Mailing address:
  • Phone: 414-333-7386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number235693
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: