Healthcare Provider Details

I. General information

NPI: 1366355315
Provider Name (Legal Business Name): NOELLE KLATT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36500 AURORA DR
SUMMIT WI
53066-4899
US

IV. Provider business mailing address

533 PARTRIDGE CT
SULLIVAN WI
53178-9675
US

V. Phone/Fax

Practice location:
  • Phone: 414-379-2580
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1115102
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: