Provider Demographics
NPI:1760806327
Name:KATHLEEN SCHWANTES
Entity Type:Organization
Organization Name:KATHLEEN SCHWANTES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTER NURSE
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWANTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-778-0190
Mailing Address - Street 1:436 W PINE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:WI
Mailing Address - Zip Code:53813-1240
Mailing Address - Country:US
Mailing Address - Phone:608-778-0190
Mailing Address - Fax:
Practice Address - Street 1:436 W PINE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:WI
Practice Address - Zip Code:53813-1240
Practice Address - Country:US
Practice Address - Phone:608-778-0190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI313086-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty