KATELYN SENEBOUTTARATH (NPI# 1306452602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306452602 |
| Entity Type | Individual |
| Full Name | KATELYN SENEBOUTTARATH |
| Practice Address |
2031 S Webster Ave Green Bay WI 54301-2257 |
| Mailing Address |
309 Laverne Dr Apt 5 Green Bay WI 54311-7176 |
| Practice Telephone | 2624089967 |
| Mailing Telephone | 2624089967 |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-09-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 5563-12 | WI | Chiropractic Providers |
| Street Address |
2031 S WEBSTER AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-2257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265508873 | Brian Thomas Dovorany | Chiropractor | 2031 S Webster Ave, Suite A, Green Bay, WI 54301-2257 | 2006-11-27 |
| 1477892412 | Stacey M Nellen-kolze | Prosthetic/Orthotic Supplier | 2031 S Webster Ave, Suite B, Green Bay, WI 54301-2257 | 2013-02-12 |
| 1013289743 | New Hair, LLC | Prosthetic/Orthotic Supplier | 2031 S Webster Ave, Suite B, Green Bay, WI 54301-2257 | 2012-01-26 |
| 1861779977 | Posture and Spine Care Center Sc | Chiropractor | 2031 S Webster Ave, Suite A, Green Bay, WI 54301-2257 | 2011-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861916769 | Atlas Spinal Care | Chiropractor | 2069 Central Ct, Suite 11, Green Bay, WI 54311 | 2017-08-01 |
| 1376067413 | Tyler Allen Malueg | Chiropractor | 2069 Central Ct Ste 11, Green Bay, WI 54311-4281 | 2017-07-31 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1982082277 | Matthew Hallam | Chiropractor | 1541 Bellevue St Ste 5, Green Bay, WI 54311-6266 | 2015-05-07 |
| 1861893018 | Leah Hetebrueg | Chiropractor | 2066 Central Dr, Unit D, Green Bay, WI 54311-4244 | 2014-09-08 |
| 1518368836 | Jesse Anderson | Chiropractor | 982 N Taylor St, Green Bay, WI 54303-1202 | 2014-09-05 |
| 1043556780 | Kellen James Binder | Chiropractor | 2638 Tulip Lane, Suite B, Green Bay, WI 54313 | 2012-12-28 |
| 1083980981 | Healthy Living Chiropractic Clinic Inc. | Chiropractor | 858 Hansen Rd, Green Bay, WI 54304-5324 | 2012-03-26 |
| 1730409111 | Cornerstone Chiropractic Sc | Chiropractor | 2763 S Oneida St, Green Bay, WI 54304-5750 | 2010-06-08 |
| 1689906240 | Hazuka Spinal Center Inc | Chiropractor | 1742 E Mason St, Green Bay, WI 54302-3259 | 2010-02-08 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.