Healthcare Provider Details

I. General information

NPI: 1497033609
Provider Name (Legal Business Name): KATHERINE LYNN ERSTAD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE LYNN KARBON

II. Dates (important events)

Enumeration Date: 07/22/2011
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 W CALUMET ST
APPLETON WI
54915-4934
US

IV. Provider business mailing address

145 W CALUMET ST
APPLETON WI
54915-4934
US

V. Phone/Fax

Practice location:
  • Phone: 920-967-4141
  • Fax: 833-972-1585
Mailing address:
  • Phone: 920-967-4141
  • Fax: 833-972-1585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTEMP
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4894
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4894-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: