Provider Demographics
NPI:1154685485
Name:WRIGHT, KATIE ELIZABETH (RN, MSN, CNM, APRN)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:ELIZABETH
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:RN, MSN, CNM, APRN
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:WRIGHT
Other - Last Name:BOGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, CNM
Mailing Address - Street 1:PO BOX 860912
Mailing Address - Street 2:SUITE 255
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55486-0912
Mailing Address - Country:US
Mailing Address - Phone:507-625-4031
Mailing Address - Fax:507-284-0702
Practice Address - Street 1:1025 MARSH ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4752
Practice Address - Country:US
Practice Address - Phone:507-625-4031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN658367A00000X
OR201503996NP-PP367A00000X
WAAP60392296367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1154685485Medicaid