MEDICARE: KATELYN RANKIN OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	5170-26	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5170-26	OTHER	WI	5170-26 WI LICENSE

General Provider Information

NPI Number	:	1487910634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN RANKIN OTR

Provider Business Mailing Address
First Line	:	1230 MICHIGAN ST
Second Line	:
City	:	STURGEON BAY
State	:	WI
Zip	:	54235-1431
Country	:	US
Telephone Number	:	920-746-2816
Fax Number	:

Provider Business Practice Location Address
First Line	:	1230 MICHIGAN ST
Second Line	:
City	:	STURGEON BAY
State	:	WI
Zip	:	54235-1431
Country	:	US
Telephone Number	:	920-746-2816
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2012
Last Update Date	:	05/07/2026

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Directions to “ KATELYN RANKIN OTR” Practice Location

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