Provider Demographics
NPI:1891387783
Name:REED, KATHERINE C (APRN, CNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:C
Last Name:REED
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:C
Other - Last Name:ROTELLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, CNP
Mailing Address - Street 1:937 SHERIDAN CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-9273
Mailing Address - Country:US
Mailing Address - Phone:440-856-6667
Mailing Address - Fax:
Practice Address - Street 1:1310 N MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:IL
Practice Address - Zip Code:60548-1397
Practice Address - Country:US
Practice Address - Phone:815-786-8484
Practice Address - Fax:815-786-7153
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209022847363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily