Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Rebecca L Ketterhagen, PA

Individual provider Physician Assistant · NPI 1871004655

Rebecca L Ketterhagen, PA is a Physician Assistant in Green Bay, Wisconsin. Qualified in 2017, 9 years ago. Practices with St Vincent Hospital-Hospital Sisters-Third Order of St Francis, a 594-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
9
Licensed in
WI
In the registry since
2017
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1726 Shawano Ave
Green Bay, WI 54303-3216
Phone: (920) 429-1700
Fax: (920) 830-5970
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 100 County Road B, Shawano, WI 54166 — (715) 524-2161

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4227 (WI)

Record details

NPI number1871004655
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 19, 2017
Last updated in NPPESMarch 23, 2022
Certification dateMarch 23, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice St Vincent Hospital-Hospital Sisters-Third Order Of St Francis — 594 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations10 on file with Medicare

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