Provider Demographics
NPI:1649679119
Name:NELSON, KATE E (PA)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:E
Last Name:NELSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:E
Other - Last Name:ORGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1200 OAKLEAF WAY
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:WI
Mailing Address - Zip Code:54720-2245
Mailing Address - Country:US
Mailing Address - Phone:715-832-1400
Mailing Address - Fax:715-832-4187
Practice Address - Street 1:1200 OAKLEAF WAY
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:WI
Practice Address - Zip Code:54720-2245
Practice Address - Country:US
Practice Address - Phone:715-832-1400
Practice Address - Fax:715-832-4187
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI201315163W00000X
WI3416363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No163W00000XNursing Service ProvidersRegistered Nurse