1649557489 NPI number — KATHERINE ANDRIES STODOLA APNP

Table of content: DR. AARON HANDS PH.D. (NPI 1003398074)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649557489 NPI number — KATHERINE ANDRIES STODOLA APNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STODOLA
Provider First Name:
KATHERINE
Provider Middle Name:
ANDRIES
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOWELL
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
ANDRIES
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1649557489
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2917 INTERNATIONAL LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MADISON
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53704-3135
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-240-0020
Provider Business Mailing Address Fax Number:
608-246-8428

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2425 NEW PINERY RD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
PORTAGE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53901-1300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-742-8900
Provider Business Practice Location Address Fax Number:
866-561-2682
Provider Enumeration Date:
11/08/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  148406-30 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LG0600X , with the licence number: 4693-33 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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