Provider Demographics
NPI:1013238047
Name:ZILLI, KATIE L (FNP)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:L
Last Name:ZILLI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:L
Other - Last Name:KNOELKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6800
Mailing Address - Fax:414-805-6805
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6800
Practice Address - Fax:414-805-6805
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI151630363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1013238047Medicaid
WI1013238047Medicaid