Healthcare Provider Details

I. General information

NPI: 1649119751
Provider Name (Legal Business Name): JANNA KAETTERHENRY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 MORELAND AVE
SCHOFIELD WI
54476-1049
US

IV. Provider business mailing address

406 MORELAND AVE
SCHOFIELD WI
54476-1049
US

V. Phone/Fax

Practice location:
  • Phone: 715-218-3847
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number162337-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: