Provider Demographics
NPI:1194461103
Name:MUGLER, KATELYNNE (MSN, FNP-BC, OCN)
Entity Type:Individual
Prefix:
First Name:KATELYNNE
Middle Name:
Last Name:MUGLER
Suffix:
Gender:F
Credentials:MSN, FNP-BC, OCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 1ST AVE APT 3C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-2278
Mailing Address - Country:US
Mailing Address - Phone:609-941-4406
Mailing Address - Fax:
Practice Address - Street 1:1184 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6503
Practice Address - Country:US
Practice Address - Phone:212-241-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF346554363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily