Kathleen M. Vandrunen
Individual provider Active NPI Physical Therapist · Appleton, WI
NPI 1013041235 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1013041235
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2280 (WI)
- Practice address
- 2915 N Meade St
Appleton, WI 54911-1509 - Phone
- (920) 831-8711
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2280 | WI | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2280 | WI | Yes |
Addresses
Primary practice location
2915 N Meade St
Appleton, WI 54911-1509
Mailing address
2915 N Meade St
Appleton, WI 54911-1509
Phone (920) 831-8711
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40099200 | Medicaid | WI |
Other providers in Appleton, WI
- Constance Mary Vandermoss
- Catherine Ann Vanderpas
- Wanda L Vanderwyst
- Tyler L Vanderzanden
- Stephanie Lynn Vandewettering
- Danielle L Vanevenhoven
- Ryan Vanevenhoven
- Maika Vang
- Salad Vang
- Sher Vang
All providers in Appleton, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.