Individual
KIRSTEN D PETHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
145 W CALUMET ST, APPLETON, WI 54915-4934
(920) 967-4141
(833) 972-1585
Mailing address
145 W CALUMET ST, APPLETON, WI 54915-4934
(833) 972-1585
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11202
MN
363A00000X
Physician Assistant
Primary
5206
WI
Other
Enumeration date
08/01/2012
Last updated
11/05/2025
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