Provider Demographics
NPI:1336452440
Name:JOSKI, KATRINA NGUYEN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:NGUYEN
Last Name:JOSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 W ASHLAND WAY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8177
Mailing Address - Country:US
Mailing Address - Phone:414-858-0100
Mailing Address - Fax:
Practice Address - Street 1:11211 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-1035
Practice Address - Country:US
Practice Address - Phone:414-454-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-17
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3912-23363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA133645244Medicaid
CA133645244Medicaid