Katherine D Bartz, PAC

Individual provider Active NPI Physician Assistant · Milwaukee, WI

NPI 1497033682 · NPPES record last updated Mar 5, 2015

Key facts

NPI
1497033682
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
2767 (WI)
Practice address
9200 W Wisconsin Ave
Division of Neoplastic Diseases
Milwaukee, WI 53226-3522
Phone
(414) 805-4600
Fax
(414) 805-6805
NPI assigned
Jul 22, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2767WIMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2767 WI Yes

Addresses

Primary practice location

9200 W Wisconsin Ave
Division of Neoplastic Diseases
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Division of Neoplastic Diseases
Milwaukee, WI 53226-3522
Phone (414) 805-4600

Other identifiers

IdentifierTypeStateIssuer
1497033682MedicaidWI

Other names

  • Katherine D Sprung Former name

Other providers in Milwaukee, WI

All providers in Milwaukee, WI · Physician Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.