Provider Demographics
NPI:1235427253
Name:PISKULA, KATHRYN LYNNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:LYNNE
Last Name:PISKULA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5017 BUENA PARK RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53185-3341
Mailing Address - Country:US
Mailing Address - Phone:262-514-3489
Mailing Address - Fax:
Practice Address - Street 1:5017 BUENA PARK RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:WI
Practice Address - Zip Code:53185-3341
Practice Address - Country:US
Practice Address - Phone:262-514-3489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI107921-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse