Healthcare Provider Details

I. General information

NPI: 1629073507
Provider Name (Legal Business Name): SUSAN KATHLENN KARTES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 WEST NATIONAL AVENUE
MILWAUKEE WI
53295
US

IV. Provider business mailing address

5382 S CAMBRIDGE LN
GREENFIELD WI
53221-3200
US

V. Phone/Fax

Practice location:
  • Phone: 414-384-2000
  • Fax:
Mailing address:
  • Phone: 414-282-4193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number56735-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: