Provider Demographics
NPI:1457530156
Name:RABOIN, KATHLEEN CECELIA (RN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:CECELIA
Last Name:RABOIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SURING
Mailing Address - State:WI
Mailing Address - Zip Code:54174-9012
Mailing Address - Country:US
Mailing Address - Phone:920-842-4132
Mailing Address - Fax:920-842-4133
Practice Address - Street 1:913 MAIN ST
Practice Address - Street 2:
Practice Address - City:SURING
Practice Address - State:WI
Practice Address - Zip Code:54174-9012
Practice Address - Country:US
Practice Address - Phone:920-842-4132
Practice Address - Fax:920-842-4133
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI125805-30163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator