Peninnah M Kako, APNP
Individual provider Active NPI Nurse Practitioner · Butler, WI
NPI 1720172745 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720172745
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 1806-033 (WI)
- Practice address
- 12601 W Hampton Avenue
Suite 100a
Butler, WI 53007 - Phone
- (262) 373-1869
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1806-033 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Past | Accepting new patients | |
| Aurora Quick Care, LLC | Nurse Practitioner | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1806-033 | WI | Yes |
Addresses
Primary practice location
12601 W Hampton Avenue
Suite 100a
Butler, WI 53007
Mailing address
9619 Beachwood Avenue
Milwaukee, WI 53224
Phone (414) 353-8788
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43930800 | Medicaid | WI |
Other providers in Butler, WI
- Donald E Dlouhy
- Laura Ann Dolphin
- Donald E. Dlouhy LLC
- Guardian Personal Care Services, LLC
- Austin Reeves Hamill
- Vanessa C Kramasz
- Denise M Kuhaupt
- Leslie Miller
- Mind Body Soulutions
- New Leaf Home Care, LLC
All providers in Butler, WI · Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.