Provider Demographics
NPI:1497033609
Name:ERSTAD, KATHERINE LYNN (NP)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LYNN
Last Name:ERSTAD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:LYNN
Other - Last Name:KARBON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:145 W CALUMET ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-4934
Mailing Address - Country:US
Mailing Address - Phone:920-967-4141
Mailing Address - Fax:833-972-1585
Practice Address - Street 1:145 W CALUMET ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-4934
Practice Address - Country:US
Practice Address - Phone:920-967-4141
Practice Address - Fax:833-972-1585
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTEMP363LF0000X
WI4894363LF0000X
WI4894-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily