Provider Demographics
NPI:1255825162
Name:FRANKWICK, KATELYN MARIE (PA)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARIE
Last Name:FRANKWICK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:MARIE
Other - Last Name:WILLFAHRT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6568 COUNTY RD N
Mailing Address - Street 2:
Mailing Address - City:ARPIN
Mailing Address - State:WI
Mailing Address - Zip Code:54410-9618
Mailing Address - Country:US
Mailing Address - Phone:715-305-6908
Mailing Address - Fax:
Practice Address - Street 1:1011 E SPRUCE ST # 6
Practice Address - Street 2:
Practice Address - City:ABBOTSFORD
Practice Address - State:WI
Practice Address - Zip Code:54405-9647
Practice Address - Country:US
Practice Address - Phone:715-223-3278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical