Provider Demographics
NPI:1265716351
Name:HELLMER, KATHERINE FIXMER (OTR)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:FIXMER
Last Name:HELLMER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-1864
Mailing Address - Country:US
Mailing Address - Phone:608-873-6611
Mailing Address - Fax:608-873-1182
Practice Address - Street 1:900 RIDGE ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589-1864
Practice Address - Country:US
Practice Address - Phone:608-873-6611
Practice Address - Fax:608-873-1182
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1163-26282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access