Provider Demographics
NPI:1720869043
Name:WASSER, KATRINA A (RN)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:A
Last Name:WASSER
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 1:408 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:BELLE PLAINE
Mailing Address - State:KS
Mailing Address - Zip Code:67013-1305
Mailing Address - Country:US
Mailing Address - Phone:316-215-2453
Mailing Address - Fax:
Practice Address - Street 1:408 N LINCOLN ST
Practice Address - Street 2:
Practice Address - City:BELLE PLAINE
Practice Address - State:KS
Practice Address - Zip Code:67013-1305
Practice Address - Country:US
Practice Address - Phone:316-215-2453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-119123163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse