Individual
KATELYN JENELLE MOHRBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2201 LAKE SHORE DR E, ASHLAND, WI 54806
(715) 685-6600
(715) 685-6601
Mailing address
2201 LAKE SHORE DR E, ASHLAND, WI 54806-2331
(715) 685-6600
(715) 685-6601
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
56647
MN
207Q00000X
Family Medicine Physician
Primary
70653
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001-0105078
MEDICA
—
01
—
1659631919
BCBS
MN
05
—
1659631919
—
MN
01
—
P01224926
RR MEDICARE
—
Enumeration date
05/21/2012
Last updated
12/04/2020
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