Healthcare Provider Details

I. General information

NPI: 1073754750
Provider Name (Legal Business Name): KATHERINE ELIZABETH DONOHUE-NELSON BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 03/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 SAINT ANDREW ST
LA CROSSE WI
54603-3301
US

IV. Provider business mailing address

N5565 GRAY HORSE RD
WEST SALEM WI
54669-9374
US

V. Phone/Fax

Practice location:
  • Phone: 608-785-5968
  • Fax:
Mailing address:
  • Phone: 608-786-1977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: