Provider Demographics
NPI:1730174863
Name:ROZEMA, KATHY A (MS, APNP, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:A
Last Name:ROZEMA
Suffix:
Gender:F
Credentials:MS, APNP, FNP-BC
Other - Prefix:MS
Other - First Name:KATHY
Other - Middle Name:A
Other - Last Name:SHARP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, RN
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6041 BASSWOOD DR
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53719
Practice Address - Country:US
Practice Address - Phone:608-504-4500
Practice Address - Fax:608-504-4510
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI156181-30163W00000X
WI2960-033363LF0000X
PASP008605363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q51872Medicare UPIN
002700122Medicare PIN