Individual provider Active NPI

Kathy Ann Brattain, APNP

  • Family Nurse Practitioner
  • Marinette, WI
National Provider Identifier
1033509963
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6025-33 Issued in WI
Practice address
3200 Shore Dr
Suite 4
Marinette, WI 54143-4292
Phone
(715) 732-8610
Fax
(715) 732-8650
NPI assigned
Jan 30, 2015
Last updated
Oct 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6025-33 WI Primary

Addresses

Primary practice location

3200 Shore Dr
Suite 4
Marinette, WI 54143-4292

Mailing address

PO Box 1866
Green Bay, WI 54305-1866
Phone (920) 445-7226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6025-33WIMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1033509963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1866",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543051866",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SHORE DR",
            "address_2": "SUITE 4",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434292",
            "telephone_number": "715-732-8610",
            "fax_number": "715-732-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATTAIN",
        "first_name": "KATHY",
        "middle_name": "ANN",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-30",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "6025-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.