Healthcare Provider Details

I. General information

NPI: 1235643214
Provider Name (Legal Business Name): KATHERINE LEIGH SOHM MSN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2017
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 PINE RIDGE BLVD
WAUSAU WI
54401-4123
US

IV. Provider business mailing address

LAHEY HOSPITAL & MEDICAL CENTER 41 MALL ROAD
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 758-472-4801
  • Fax:
Mailing address:
  • Phone: 781-744-7000
  • Fax: 781-744-5351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1353433
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2319477
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: