Provider Demographics
NPI:1154865251
Name:JARRIN, KATASHA (FNP)
Entity Type:Individual
Prefix:
First Name:KATASHA
Middle Name:
Last Name:JARRIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KATASHA
Other - Middle Name:
Other - Last Name:JARRIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:300 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-3297
Mailing Address - Country:US
Mailing Address - Phone:910-904-6600
Mailing Address - Fax:
Practice Address - Street 1:4001 CUMBERLAND RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-6703
Practice Address - Country:US
Practice Address - Phone:910-426-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-07
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009144363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily