Provider Demographics
NPI:1538720594
Name:KERSTEN, KAITLIN (OTD, EMT-P)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:KERSTEN
Suffix:
Gender:F
Credentials:OTD, EMT-P
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:
Other - Last Name:FRANK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:595 ENGLISH LN
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-8755
Mailing Address - Country:US
Mailing Address - Phone:815-291-8404
Mailing Address - Fax:
Practice Address - Street 1:615 ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:FENNIMORE
Practice Address - State:WI
Practice Address - Zip Code:53809-1130
Practice Address - Country:US
Practice Address - Phone:563-583-4003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist