Provider Demographics
NPI:1093898066
Name:RANSCHAU, KATHRYN JOAN (PA)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:JOAN
Last Name:RANSCHAU
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 S GREENE ST
Mailing Address - Street 2:
Mailing Address - City:ROCK RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:51246-1948
Mailing Address - Country:US
Mailing Address - Phone:712-472-3716
Mailing Address - Fax:712-472-2878
Practice Address - Street 1:803 S GREENE ST
Practice Address - Street 2:
Practice Address - City:ROCK RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:51246
Practice Address - Country:US
Practice Address - Phone:712-472-3716
Practice Address - Fax:712-472-2878
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001276363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0638700Medicaid
IA0250498Medicaid
IA0250498Medicaid
IAI5034Medicare ID - Type UnspecifiedMEDICARE PART B GROUP #