Ketterhagen, Katherine D.
Ketterhagen, Katherine D. is an individual health care provider with primary practice located at 3200 E Racine St , Janesville WI 53546-2343. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Ketterhagen, Katherine D. can be contacted via phone (608) 371-8000.Contact Information
Primary practice address
3200 E Racine St
Janesville WI 53546-2343
Phone: (608) 371-8000
Fax: (608) 371-8008
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1757-23 | Wisconsin |
Profile Details
| NPI number | 1356414668 |
|---|---|
| LBN Legal business name | Ketterhagen, Katherine D. |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 16th, 2006 |
| Last updated | Nov 3rd, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356414668 | NPPES |
| Wisconsin | MEDICAID | 41992300 | |
| Wisconsin | Other | 61167 |
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