Provider Demographics
NPI:1487084984
Name:HIND, KATHRYN LEIGH (RN)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:LEIGH
Last Name:HIND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:KATHRYN
Other - Middle Name:LEIGH
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1626 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-2516
Mailing Address - Country:US
Mailing Address - Phone:605-929-1876
Mailing Address - Fax:
Practice Address - Street 1:1626 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-2516
Practice Address - Country:US
Practice Address - Phone:605-929-1876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI170108163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse