Provider Demographics
NPI:1174043889
Name:KATONA, MICHAEL D (NP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:KATONA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3860 S STRAITS HWY
Mailing Address - Street 2:
Mailing Address - City:INDIAN RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49749-5146
Mailing Address - Country:US
Mailing Address - Phone:231-238-0581
Mailing Address - Fax:989-731-7929
Practice Address - Street 1:3860 S STRAITS HWY
Practice Address - Street 2:
Practice Address - City:INDIAN RIVER
Practice Address - State:MI
Practice Address - Zip Code:49749-5146
Practice Address - Country:US
Practice Address - Phone:231-238-0581
Practice Address - Fax:989-731-7929
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704280087363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily