KATHRYN JANE BUTKOVICH (NPI# 1740665389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740665389 |
| Entity Type | Individual |
| Full Name | KATHRYN JANE BUTKOVICH |
| Other Name | KATHRYN JANE HANDRICK |
| Credential | CPNP-PC |
| Practice Address |
1821 S Webster Ave Green Bay WI 54301 |
| Mailing Address |
1821 S Webster Ave Green Bay WI 54301-2253 |
| Practice Telephone | 9204964700 |
| Mailing Telephone | 9204964700 |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2019-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 193019-30 | WI | Nursing Service Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
6620 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1740665389 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9000 W Wisconsin Ave, Pediatric Genetics, Milwaukee, WI 532264874 | 4142662979 | 4142661616 |
| Street Address |
1821 S WEBSTER AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821091679 | Jerald P Marifke | Internal Medicine | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2005-05-24 |
| 1144858713 | Dawn P Mccullough | Nurse Practitioner | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2020-03-30 |
| 1881230266 | Kasey Jankowski | Physician Assistant | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2019-11-21 |
| 1699247486 | Erin Joanne Broda | Advanced Practice Midwife | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2018-12-18 |
| 1467928440 | Ashley Naas | Physical Therapist | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2018-10-17 |
| 1689167942 | Marissa Adrian | Physician Assistant | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2018-06-12 |
| 1427585736 | Nicole Will | Physical Medicine & Rehabilitation | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2017-05-17 |
| 1588111215 | Jennifer Gibbons | Registered Nurse | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2016-09-11 |
| 1639520414 | Lauren Isabel Useem | Obstetrics & Gynecology | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2016-06-23 |
| 1437506110 | Jessica Zarzecki | Physician Assistant | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2016-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487884623 | Audra Hermanson | Nurse Practitioner | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2009-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159964 | Caitlin West | Nurse Practitioner | 10823 N Ravine Ct, Mequon, WI 53092-5876 | 2020-06-18 |
| 1639704166 | Angelica Shanahan | Nurse Practitioner | 8733 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2020-03-04 |
| 1609408210 | Jenna Rae Eisold | Nurse Practitioner | 65 W Wood Ridge Dr, River Falls, WI 54022-8291 | 2020-02-11 |
| 1639685274 | Laura Palmer | Nurse Practitioner | 4855 S Moorland Rd # Rod, New Berlin, WI 53151-7494 | 2017-12-19 |
| 1306356589 | Alexandra Wilson | Nurse Practitioner | 3033 W Layton Ave # 102, Greenfield, WI 53221-2628 | 2017-10-02 |
| 1689192775 | Brigid Mary Costello | Nurse Practitioner | 9000 W Wisconsin Ave Ste 620, Milwaukee, WI 53226-4874 | 2017-09-08 |
| 1851643696 | Jamie Harder | Nurse Practitioner | 2574 Sun Valley Dr Ste 207, Delafield, WI 53018-2334 | 2012-10-03 |
| 1760731988 | Nancy J Thompson-quandt | Nurse Practitioner | 7831 Warren Ave, Wauwatosa, WI 53213-2115 | 2012-09-04 |
| 1932471018 | Marie Helen Dietrich | Nurse Practitioner | 201 S Gammon Rd, Madison, WI 53717-1404 | 2012-02-03 |
| 1598993925 | Rebecca R. Rusch | Nurse Practitioner | 13950 W. W. Capitol Drive, Suite 200, Brookfield, WI 53005-2441 | 2009-06-24 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KATHRYN JANE BUTKOVICH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.