Provider Demographics
NPI:1073773677
Name:KATCHKO, SUZETTE LINDA (APNP)
Entity Type:Individual
Prefix:MRS
First Name:SUZETTE
Middle Name:LINDA
Last Name:KATCHKO
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:MISS
Other - First Name:SUZETTE
Other - Middle Name:LINDA
Other - Last Name:RAISBECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:3144 VANZILE RD
Mailing Address - Street 2:
Mailing Address - City:CRANDON
Mailing Address - State:WI
Mailing Address - Zip Code:54520-8149
Mailing Address - Country:US
Mailing Address - Phone:715-478-5180
Mailing Address - Fax:715-478-5904
Practice Address - Street 1:3144 VANZILE RD
Practice Address - Street 2:
Practice Address - City:CRANDON
Practice Address - State:WI
Practice Address - Zip Code:54520-8149
Practice Address - Country:US
Practice Address - Phone:715-478-5180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3553363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner