Provider Demographics
NPI:1518199025
Name:HERRINGA, KATHRYN DANA (NP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:DANA
Last Name:HERRINGA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-5002
Mailing Address - Country:US
Mailing Address - Phone:608-630-2162
Mailing Address - Fax:
Practice Address - Street 1:2705 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-5002
Practice Address - Country:US
Practice Address - Phone:608-266-4821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009482363LW0102X
WI2136-33363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health