Healthcare Provider Details

I. General information

NPI: 1366212748
Provider Name (Legal Business Name): KATHERINE RAHENKAMP APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2024
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 S 4TH ST
DANVILLE KY
40422-2091
US

IV. Provider business mailing address

1431 OPUS PL STE 110
DOWNERS GROVE IL
60515-1164
US

V. Phone/Fax

Practice location:
  • Phone: 859-236-1080
  • Fax:
Mailing address:
  • Phone: 888-279-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4008837
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: