Active NPI
Katelyn Bracken
- Registered Nurse
- Deerfield, WI
National Provider Identifier
1114595261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 261108
- Practice address
- 1515 Hommen Rd
Deerfield, WI 53531-9678 - Phone
- (608) 577-7278
- NPI assigned
- Jun 15, 2021
- Last updated
- Jul 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 261108 | WI | Primary |
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
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 261108 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626307200000",
"number": "1114595261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2675 N PARK LN APT 220",
"city": "FITCHBURG",
"state": "WI",
"postal_code": "537111698",
"telephone_number": "608-577-7278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 HOMMEN RD",
"city": "DEERFIELD",
"state": "WI",
"postal_code": "535319678",
"telephone_number": "608-577-7278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRACKEN",
"first_name": "KATELYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-15",
"last_updated": "2021-07-15",
"certification_date": "2021-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "261108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deerfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.