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NPI Code Detail

MEDICARE: KAREN KOMORNICKA RN, NP

MEDICARE: KAREN KOMORNICKA RN, NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse102451WI
2163WC1600XContinuing Education/Staff Development Registered Nurse102451WI
3163WC2100XContinence Care Registered Nurse102451WI
4163WG0000XGeneral Practice Registered Nurse102451WI
5163WG0600XGerontology Registered Nurse102451WI
6163WW0000XWound Care Registered Nurse102451WI
7163WX1500XOstomy Care Registered Nurse102451WI
8363L00000XNurse Practitioner799WI
9363LA2200XAdult Health Nurse Practitioner799WI
10363LF0000XFamily Nurse Practitioner799WI
11363LG0600XGerontology Nurse Practitioner799WI
12364SL0600XLong-Term Care Clinical Nurse Specialist799WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1799OTHERWISTATE LICENSE NP
2102451OTHERWISTATE LICENSE RN

General Provider Information

NPI Number : 1235126822
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN KOMORNICKA RN, NP
Provider Business Mailing Address
First Line : 3023 S 84TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-3703
Country : US
Telephone Number : 414-607-4100
Fax Number : 414-607-4502
Provider Business Practice Location Address
First Line : 8520 W OKLAHOMA AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-4604
Country : US
Telephone Number : 414-607-4100
Fax Number : 414-607-4502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2005
Last Update Date : 03/07/2023

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