Provider Demographics
NPI:1477074169
Name:HALL, KATE A (PA-C)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:A
Last Name:HALL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:A
Other - Last Name:RENTSCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16909 LAKESIDE HILLS CT STE 208
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-4663
Mailing Address - Country:US
Mailing Address - Phone:402-717-0820
Mailing Address - Fax:402-717-6061
Practice Address - Street 1:16909 LAKESIDE HILLS CT
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-4664
Practice Address - Country:US
Practice Address - Phone:402-717-0820
Practice Address - Fax:402-717-6061
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2298363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant