Individual provider · NPI-1

Katherine Braddock

Home Health · Racine, WI

NPI number1366834376
StatusActive
Last updated in NPPESFeb 27, 2015

Details

NPI
1366834376
Entity type
Individual (NPI-1)
Name
Katherine Braddock
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 27, 2015
Last updated
Feb 27, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home Health1187WIYes

Practice location

403 Sixth St
Racine, WI 53403-1217

Phone 262-210-6960

Mailing address

3806 Lakeview Dr
Mt Pleasant, WI 53403-9405

Phone 262-210-6960

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