Provider Demographics
NPI:1902580160
Name:MILESKI, CATHY LEE
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:LEE
Last Name:MILESKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 BRIARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-2456
Mailing Address - Country:US
Mailing Address - Phone:920-562-4597
Mailing Address - Fax:
Practice Address - Street 1:1808 BRIARWOOD CT
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-2456
Practice Address - Country:US
Practice Address - Phone:920-562-4597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI151557163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice