Kathleen A Rezba, RDH
Individual provider Active NPI Dental Hygienist · Cato, WI
NPI 1770169880 · NPPES record last updated Mar 19, 2021
Key facts
- NPI
- 1770169880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 6669-016 (WI)
- Practice address
- 12112 Fisherville Rd
Cato, WI 54230-8026 - Phone
- (920) 901-3740
- NPI assigned
- Mar 19, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 6669-016 | WI | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hygeia Corp | Dental Hygienist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 6669-016 | WI | Yes |
Addresses
Primary practice location
12112 Fisherville Rd
Cato, WI 54230-8026
Mailing address
12112 Fisherville Rd
Cato, WI 54230-8026
Phone (920) 901-3740
Other providers in Cato, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 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.