Provider Demographics
NPI:1619061611
Name:CATES, RONDA LEAH (ADN)
Entity Type:Individual
Prefix:MRS
First Name:RONDA
Middle Name:LEAH
Last Name:CATES
Suffix:
Gender:F
Credentials:ADN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 WARNER ST
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-4758
Mailing Address - Country:US
Mailing Address - Phone:715-252-9213
Mailing Address - Fax:
Practice Address - Street 1:2531 WARNER ST
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-4758
Practice Address - Country:US
Practice Address - Phone:715-252-9213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35005000Medicaid