Basic Information
Provider Information
NPI: 1972907855
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUCHENE
FirstName: KATE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7581 9TH ST N STE 100
Address2:  
City: OAKDALE
State: MN
PostalCode: 551286635
CountryCode: US
TelephoneNumber: 6517484338
FaxNumber:  
Practice Location
Address1: 1961 CARDINAL LN STE A
Address2:  
City: FARIBAULT
State: MN
PostalCode: 550214354
CountryCode: US
TelephoneNumber: 5073332986
FaxNumber: 5073332918
Other Information
ProviderEnumerationDate: 10/21/2014
LastUpdateDate: 08/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X12925-24WIN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X28453FLN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X10202MNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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