Healthcare Provider Details

I. General information

NPI: 1023085230
Provider Name (Legal Business Name): KATHRYN A SWENSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN MORMANN

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 TROTTA CT
WAUNAKEE WI
53597-2658
US

IV. Provider business mailing address

1407 TROTTA CT
WAUNAKEE WI
53597-2658
US

V. Phone/Fax

Practice location:
  • Phone: 608-213-7010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2625
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: