KATHERINE D. KETTERHAGEN (NPI# 1356414668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356414668 |
| Entity Type | Individual |
| Full Name | KATHERINE D. KETTERHAGEN |
| Other Name | KATHERINE D DANNA |
| Credential | PA-C |
| Practice Address |
3200 E Racine St Janesville WI 53546-2343 |
| Mailing Address |
1446 N Randall Ave Janesville WI 53545-1122 |
| Practice Telephone | 6083718000 |
| Practice Fax Number | 6083718008 |
| Mailing Telephone | 6087587215 |
| Mailing Fax Number | 6087583216 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-11-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1757-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41992300 | 05 | |
| WI | DEAN HEALTH SYSTEMS, INC | 61167 | 01 |
| Street Address |
3200 E RACINE ST |
| City | JANESVILLE |
| State | WI |
| Zip Code | 53546-2343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124026208 | Mark C. Torres | Obstetrics & Gynecology | 3200 E Racine St, Janesville, WI 53546-2343 | 2005-07-12 |
| 1033719703 | Macy G Bolt | Physical Therapist | 3200 E Racine St, Janesville, WI 53546-2343 | 2020-10-30 |
| 1407489016 | Joy P. Thompson | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2020-02-21 |
| 1851938419 | Hatsuho Wilkinson | Dietitian, Registered | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-12-03 |
| 1013563394 | Karrie R Lynch | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-13 |
| 1679128771 | Ellen Jean Ettlie | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-06 |
| 1881249126 | Elizabeth F Ramer | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-08-05 |
| 1093377905 | Nichole N Clark | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-07-01 |
| 1386202448 | Nicole M. Wentzien | Physical Therapist | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-06-04 |
| 1407322084 | Mark William Dantuma | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2018-10-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366911489 | Latoya Christina Anderson | Counselor | 1818 Pershing Pl, Janesville, WI 53546 | 2018-11-19 |
| 1922599216 | Megan Arney | Speech-Language Pathologist | 9680, 4445 Woodgate Dr., Janesville, WI 53546 | 2018-05-23 |
| 1770089955 | Abby Marie Harnack | Registered Nurse | 3901 Teal Ln, Janesville, WI 53546 | 2018-04-05 |
| 1962773648 | Clark Carroll | Nurse Practitioner | 1820 Center Ave, Janesville, WI 53546 | 2012-01-26 |
| 1689983793 | Fve Mw LLC | Assisted Living Facility | 3801 North Wright Road, Janesville, WI 53546 | 2010-10-07 |
| 1831354794 | County of Rock County Clerk | Community/Behavioral Health | 3506 Hwy 51, Janesville, WI 53546 | 2008-07-21 |
| 1528225422 | Walgreen Co | Pharmacy | 2519 Kettering St, Janesville, WI 53546 | 2008-05-19 |
| 1447420351 | Michele Renee Bohland | Physical Therapy Assistant | 2540 Humes Rd, Janesville, WI 53546 | 2008-03-06 |
| 1093992158 | Emma Gene Harrell | Counselor | 203 W Sunny Lane, Janesville, WI 53546 | 2008-01-30 |
| 1457473696 | Robert Louis Fleming | Dentist | 910 Conde St, Janesville, WI 53546 | 2007-04-06 |
| Find all providers in zip 53546 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346719093 | Megan E. Yarrington | Physician Assistant | 3400 Deerfield Dr, Janesville, WI 53546-3557 | 2018-11-23 |
| 1942776570 | Alyssa Kristine Rasmussen | Physician Assistant | 1000 Mineral Point Ave, Janesville, WI 53548-2940 | 2018-10-22 |
| 1447744388 | Karleen F. Mcbride | Physician Assistant | 1000 Mineral Point Ave, Janesville, WI 53548-2940 | 2018-06-14 |
| 1467976696 | Heather Clark | Physician Assistant | 3200 E Racine St, Janesville, WI 53546-2343 | 2017-07-31 |
| 1396293890 | Katherine E. Gunderson | Physician Assistant | 3400 Deerfield Dr, Janesville, WI 53546-3557 | 2016-09-14 |
| 1699158626 | Jordan L Johnson | Physician Assistant | 3200 E Racine St, Janesville, WI 53546-2343 | 2015-07-08 |
| 1285032318 | Jennifer Hamilton | Physician Assistant | 3200 E Racine St, Janesville, WI 53546-2343 | 2014-12-05 |
| 1629486006 | Elizabeth F Schaut | Physician Assistant | 3200 E Racine St, Janesville, WI 53546-2343 | 2014-07-29 |
| 1295176295 | Zachary Hathway | Physician Assistant | 1446 N Randall Ave, Janesville, WI 53545-1122 | 2013-07-08 |
| 1770928160 | Eric M. Schulz | Physician Assistant | 3524 E Milwaukee St, Janesville, WI 53546-1626 | 2013-04-30 |
| Find all providers in JANESVILLE | ||||
| City | JANESVILLE |
| Zip Code | 53546 |
Please comment or provide details below to improve the information on KATHERINE D. KETTERHAGEN.
| 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.