Provider Demographics
NPI:1679002968
Name:KAEDING, BARBARA A
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:KAEDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18450 STATE LINE RD
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61019-9602
Mailing Address - Country:US
Mailing Address - Phone:815-865-5621
Mailing Address - Fax:
Practice Address - Street 1:3915 S COUNTY ROAD K
Practice Address - Street 2:
Practice Address - City:ORFORDVILLE
Practice Address - State:WI
Practice Address - Zip Code:53576
Practice Address - Country:US
Practice Address - Phone:608-295-8002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI316352-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse