Provider Demographics
NPI:1114716420
Name:TRIMBLE, KATHERINE JOSEPHINE
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JOSEPHINE
Last Name:TRIMBLE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2113 POINT COMFORT RD
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-2247
Mailing Address - Country:US
Mailing Address - Phone:715-308-7590
Mailing Address - Fax:
Practice Address - Street 1:460 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-1827
Practice Address - Country:US
Practice Address - Phone:715-235-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program