Gendron, Kathleen R

Gendron, Kathleen R is an individual health care provider with primary practice located at 5320 Michaels Dr , Appleton WI 54913-8446. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Gendron, Kathleen R can be contacted via phone (920) 882-8200.

Contact Information

Primary practice address
5320 Michaels Dr Appleton WI 54913-8446
Phone: (920) 882-8200
Fax: (920) 882-8210
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 220003 Wisconsin

Profile Details

NPI number 1558353276
LBN Legal business name Gendron, Kathleen R
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558353276 NPPES
Wisconsin MEDICAID 4387900

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