Provider Demographics
NPI:1548920820
Name:WOHLGEMUTH, KATIE (APRN)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:WOHLGEMUTH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:WOHLGEMUTH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:631 SW HORNE ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1694
Mailing Address - Country:US
Mailing Address - Phone:785-270-5000
Mailing Address - Fax:
Practice Address - Street 1:631 SW HORNE ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1694
Practice Address - Country:US
Practice Address - Phone:785-270-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS80064363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner