Provider Demographics
NPI:1699908277
Name:BORCHERT, KATHLEEN MAE (RN, CWOCN, ACNS-BC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MAE
Last Name:BORCHERT
Suffix:
Gender:F
Credentials:RN, CWOCN, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 CAPITOL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-2101
Mailing Address - Country:US
Mailing Address - Phone:651-232-2789
Mailing Address - Fax:651-326-8502
Practice Address - Street 1:559 CAPITOL BLOULEVARD
Practice Address - Street 2:
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103
Practice Address - Country:US
Practice Address - Phone:651-232-2789
Practice Address - Fax:651-326-8502
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-28
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 102642-3364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care