Provider Demographics
NPI:1770874422
Name:MCLEOD, KATHERINE (RN, FPMHNP, APNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:RN, FPMHNP, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-3812
Mailing Address - Country:US
Mailing Address - Phone:608-757-5850
Mailing Address - Fax:608-757-5545
Practice Address - Street 1:113 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-3812
Practice Address - Country:US
Practice Address - Phone:608-757-5850
Practice Address - Fax:608-757-5545
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI131135163W00000X
WI1347-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse