Provider Demographics
NPI:1063920734
Name:CHAKRABARTI, KARI L (CRNA)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:L
Last Name:CHAKRABARTI
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:L
Other - Last Name:GITLEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
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:2018-01-16
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8476367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1063920734Medicaid