Basic Information
| Provider Information | |||||||||
| NPI: | 1588090997 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KLATT | ||||||||
| FirstName: | VALERIE | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | |||||||||
| Credential: | RN, CCRN | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MARCUM | ||||||||
| OtherFirstName: | VALERIE | ||||||||
| OtherMiddleName: | |||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | W7568 COUNTY ROAD KW | ||||||||
| Address2: | |||||||||
| City: | JUNEAU | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530399741 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9203869689 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 611 SHERMAN AVE E | ||||||||
| Address2: | |||||||||
| City: | FORT ATKINSON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 535381960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9205685000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2013 | ||||||||
| LastUpdateDate: | 09/17/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | 133602-030 | WI | Y | Nursing Service Providers | Registered Nurse | Critical Care Medicine |
No ID Information.