Healthcare Provider Details

I. General information

NPI: 1649135310
Provider Name (Legal Business Name): KATALIN SKELTON STANASZAK MSN, RN, AGCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 N 12TH ST
MILWAUKEE WI
53233-1305
US

IV. Provider business mailing address

945 N 12TH ST
MILWAUKEE WI
53233-1305
US

V. Phone/Fax

Practice location:
  • Phone: 414-509-1831
  • Fax:
Mailing address:
  • Phone: 414-509-1831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number19271630
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: