Provider Demographics
NPI:1003593039
Name:SAIN, KATHERINE ANN (APRN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:SAIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ANN
Other - Last Name:MCCLELLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5885 LAKEHURST DR APT 2129
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8357
Mailing Address - Country:US
Mailing Address - Phone:614-937-7133
Mailing Address - Fax:
Practice Address - Street 1:89 W COPELAND DR FL 1
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2002
Practice Address - Country:US
Practice Address - Phone:321-843-8900
Practice Address - Fax:352-629-3145
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11026913363LF0000X
FLAPRN11026913363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily