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General NPI Number Information
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NPI Number | 1477132728
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Entity Type | Individual
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Provider Name | KATARINA NICOLE ELYEA NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 6611 SPRING ST
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City | MOUNT PLEASANT
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State | WI
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Zip | 53406-2632
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Country | US
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Telephone | 262-504-3100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 735044
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City | CHICAGO
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State | IL
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Zip | 60673-5044
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Country | US
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Telephone | 800-326-2250
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10516
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 10516-33
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 209023339
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License Number State | IL
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