Pufahl, Kaitlyn N

Pufahl, Kaitlyn N is an individual health care provider with primary practice located at 109 Warren St Ste 4 , Beaver Dam WI 53916-3082. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Pufahl, Kaitlyn N can be contacted via phone (920) 885-3305.

Contact Information

Primary practice address
109 Warren St Ste 4 Beaver Dam WI 53916-3082
Phone: (920) 885-3305
Fax: (920) 885-5506
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 364SP0200X 4453-33 Wisconsin

Profile Details

NPI number 1710272778
LBN Legal business name Pufahl, Kaitlyn N
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2011
Last updated Jul 20th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710272778 NPPES
Wisconsin MEDICAID 21319100

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