Provider Demographics
NPI:1538545728
Name:ALVAREZ, KATHERINE LEE (APNP)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LEE
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:LEE
Other - Last Name:LAUBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:3200 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-9274
Mailing Address - Country:US
Mailing Address - Phone:262-836-7300
Mailing Address - Fax:262-836-7301
Practice Address - Street 1:3200 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-9274
Practice Address - Country:US
Practice Address - Phone:262-836-7300
Practice Address - Fax:262-836-7301
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6445-33363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1538545728Medicaid
WIK400241233Medicare PIN