Provider Demographics
NPI:1578723557
Name:VANTHIEL, KATHLEEN J (NP)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:J
Last Name:VANTHIEL
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Gender:F
Credentials:NP
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Mailing Address - Street 1:3033 S 27TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-3600
Mailing Address - Country:US
Mailing Address - Phone:414-908-6601
Mailing Address - Fax:414-385-2980
Practice Address - Street 1:1033 N MAYFAIR RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3442
Practice Address - Country:US
Practice Address - Phone:414-908-6601
Practice Address - Fax:414-385-2980
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2010-02-03
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Provider Licenses
StateLicense IDTaxonomies
WI3228-033363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health