Kathleen Cecelia Raboin, RN

Individual provider Active NPI Administrator Registered Nurse · Suring, WI

NPI 1457530156 · NPPES record last updated Oct 30, 2007

Key facts

NPI
1457530156
Entity type
Individual (NPI type 1)
Primary specialty
Administrator Registered Nurse 163WA2000X
License
125805-30 (WI)
Practice address
913 Main St
Suring, WI 54174-9012
Phone
(920) 842-4132
Fax
(920) 842-4133
NPI assigned
Oct 30, 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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
125805-30WIMDAdministrator Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 125805-30 WI Yes

Addresses

Primary practice location

913 Main St
Suring, WI 54174-9012

Mailing address

913 Main St
Suring, WI 54174-9012
Phone (920) 842-4132

Other providers in Suring, WI

All providers in Suring, WI · Administrator Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.