Provider Demographics
NPI:1114191988
Name:OPALENIK, KATHRYN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:OPALENIK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:GESTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4010 FOOTHILLS BLVD
Mailing Address - Street 2:SUTTER EXPRESS CARE
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-7241
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:8 MEDICAL PLAZA DR STE 300
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3107
Practice Address - Country:US
Practice Address - Phone:916-453-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95002369363LF0000X, 363LF0000X
WV45419363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics