Provider Demographics
NPI:1053355156
Name:GVENTER, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GVENTER
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:W67N403 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-2303
Mailing Address - Country:US
Mailing Address - Phone:262-377-8078
Mailing Address - Fax:
Practice Address - Street 1:2025 E NEWPORT AVE
Practice Address - Street 2:COLUMBIA ST MARY'S HOSPITAL
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53201-0000
Practice Address - Country:US
Practice Address - Phone:441-961-4164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI814-019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant