Basic Information
Provider Information
NPI: 1891356804
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBBINS
FirstName: KATHRYN
MiddleName: JEAN
NamePrefix: DR.
NameSuffix:  
Credential: DNP, APRN, CPNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9000 W WISCONSIN AVE
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 532264874
CountryCode: US
TelephoneNumber: 4149554170
FaxNumber:  
Practice Location
Address1: 9000 W WISCONSIN AVE
Address2:  
City: MILWAUKEE
State: WI
PostalCode: 53226
CountryCode: US
TelephoneNumber: 4149554170
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/21/2019
LastUpdateDate: 07/10/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200X9318-33WIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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