Provider Demographics
NPI:1144190109
Name:BEAUDETTE, KATHERINE
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:BEAUDETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:NE
Mailing Address - Zip Code:68421-0021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2507 SCHNEIDER AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NE
Practice Address - Zip Code:68305-3054
Practice Address - Country:US
Practice Address - Phone:402-274-4996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant