Brandi Lynne Ketterling

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A194 Issued in MN

Practice address

17630 Hemlock Ave
Lakeville, MN 55044-3908

Phone

(952) 484-3974

NPI assigned

Jul 30, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1477985646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17630 HEMLOCK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443908",
            "telephone_number": "952-484-3974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17630 HEMLOCK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443908",
            "telephone_number": "952-484-3974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTERLING",
        "first_name": "BRANDI",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Sue Kellogg
• Megan L Kelly, LAMFT
• Kenrick Chiropractic
• Brittin Kent
• Michael Clifton Kerstetter, MA
• Kids First Pediatrics, LTD
• Injung Kim, RN
• Nicholette Kimm, D.C.
• Jennifer Betty Kindem
• Brandon H King, OD

• Physical Therapy Assistant in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.