Provider Demographics
NPI:1023804630
Name:OPPERMAN, KATELYN MAY
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:MAY
Last Name:OPPERMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 4TH ST E APT 3
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057-2094
Mailing Address - Country:US
Mailing Address - Phone:651-558-7945
Mailing Address - Fax:
Practice Address - Street 1:104 4TH ST E APT 3
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-2094
Practice Address - Country:US
Practice Address - Phone:651-558-7945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker