Kathryn Marie Cacic, APNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2504-033 Issued in WI

Practice address

7752 Clinton Road
Deforest, WI 53532

Phone

(608) 846-0614

NPI assigned

Jan 10, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821147661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7752 CLINTON ROAD",
            "city": "DEFOREST",
            "state": "WI",
            "postal_code": "53532",
            "telephone_number": "608-846-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7752 CLINTON ROAD",
            "city": "DEFOREST",
            "state": "WI",
            "postal_code": "53532",
            "telephone_number": "608-846-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACIC",
        "first_name": "KATHRYN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "2504-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonita Lorraine Brossard, LPN
• Nicole Bruecker
• Renee Eve Brunner, RN
• Carla Budrow
• Rebecca Sue Burke, RPH
• Darcy Lee Coddington, PHARMD
• Laura B Cole, LPN
• Luccas Michael Contreras, APSW
• Gerald Roger Corcoran, DDS
• Tara Dahlke, BS, MA, MS

• Adult Health Nurse Practitioner in Deforest, WI
• Providers in Deforest, WI by specialty
• Adult Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.