Provider Demographics
NPI:1588090997
Name:KLATT, VALERIE (RN, CCRN)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:KLATT
Suffix:
Gender:F
Credentials:RN, CCRN
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:MARCUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:W7568 COUNTY ROAD KW
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:WI
Mailing Address - Zip Code:53039-9741
Mailing Address - Country:US
Mailing Address - Phone:920-386-9689
Mailing Address - Fax:
Practice Address - Street 1:611 SHERMAN AVE E
Practice Address - Street 2:
Practice Address - City:FORT ATKINSON
Practice Address - State:WI
Practice Address - Zip Code:53538-1960
Practice Address - Country:US
Practice Address - Phone:920-568-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI133602-030163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine