Provider Demographics
NPI:1669173993
Name:MUELLER, KATHERINE
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MUELLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 CORAL RD
Mailing Address - Street 2:
Mailing Address - City:WONDER LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60097-8211
Mailing Address - Country:US
Mailing Address - Phone:719-205-1606
Mailing Address - Fax:
Practice Address - Street 1:8701 CORAL RD
Practice Address - Street 2:
Practice Address - City:WONDER LAKE
Practice Address - State:IL
Practice Address - Zip Code:60097-8211
Practice Address - Country:US
Practice Address - Phone:719-205-1606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility