Rachel Ann Longawa Ketter, PA-C
Physician Assistant in Kenosha, WI. Individual provider (NPI-1).
NPI number1760822845
StatusActive
Last updated in NPPESJun 25, 2025
Details
- NPI
- 1760822845
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Rachel Ann Longawa Ketter
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 3, 2013
- Certification date
- Jun 25, 2025
- Last updated
- Jun 25, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085004728 | IL | Yes |
| 363A00000X | Physician Assistant | 3133-23 | WI |
Practice location
10400 75th StKenosha, WI 53142-7884
Phone 262-942-5828
Mailing address
3301 W Forest Home AveMilwaukee, WI 53215-2843
Phone 414-389-2233
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