Katelyn Bracken
Individual provider Active NPI Registered Nurse · Deerfield, WI
NPI 1114595261 · NPPES record last updated Jul 15, 2021
Key facts
- NPI
- 1114595261
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 261108 (WI)
- Practice address
- 1515 Hommen Rd
Deerfield, WI 53531-9678 - Phone
- (608) 577-7278
- NPI assigned
- Jun 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 261108 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 261108 | WI | Yes |
Addresses
Primary practice location
1515 Hommen Rd
Deerfield, WI 53531-9678
Mailing address
2675 N Park LN Apt 220
Fitchburg, WI 53711-1698
Phone (608) 577-7278
Other providers in Deerfield, WI
- Aging Gracefully Home Care LLC
- Wade Lee Anderson
- Melissa Bakken
- Deerfield Community Schools
- Heather Marie Renee Deiter
- Nicole Lynn Deon
- Robin Dene Dorn
- Lashay Edwards
All providers in Deerfield, WI · Registered Nurse 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 15, 2021. 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.