MEDICARE: KATERINA GILBERTSON

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
1	163W00000X	Registered Nurse	235331-30	WI

General Provider Information

NPI Number	:	1518436971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATERINA GILBERTSON

Provider Business Mailing Address
First Line	:	1416 JENIFER ST
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53703-3719
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1416 JENIFER ST
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53703-3719
Country	:	US
Telephone Number	:	608-257-6567
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2018
Last Update Date	:	11/15/2018

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Directions to “ KATERINA GILBERTSON ” Practice Location

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