Provider Demographics
NPI:1689878092
Name:MCWEY, KATHLEEN TRIER (APN-CPNP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:TRIER
Last Name:MCWEY
Suffix:
Gender:F
Credentials:APN-CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 MICHELLE WITMER MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-5292
Mailing Address - Country:US
Mailing Address - Phone:262-789-6020
Mailing Address - Fax:
Practice Address - Street 1:3610 MICHELLE WITMER MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-5292
Practice Address - Country:US
Practice Address - Phone:262-789-6020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209006560363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics