Provider Demographics
NPI:1265915250
Name:WINGATE, KATHRYN ANN (DNP FNP-C PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:WINGATE
Suffix:
Gender:F
Credentials:DNP FNP-C PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3703 OAKWOOD HILLS PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-4458
Mailing Address - Country:US
Mailing Address - Phone:534-444-4562
Mailing Address - Fax:
Practice Address - Street 1:3703 OAKWOOD HILLS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-4458
Practice Address - Country:US
Practice Address - Phone:715-485-8402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8656-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner