Provider Demographics
NPI:1295607901
Name:POWERS-PYGOTT, KATLYNN
Entity type:Individual
Prefix:
First Name:KATLYNN
Middle Name:
Last Name:POWERS-PYGOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W HAY ST
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-4162
Mailing Address - Country:US
Mailing Address - Phone:217-876-6860
Mailing Address - Fax:217-876-6868
Practice Address - Street 1:301 W HAY ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-4162
Practice Address - Country:US
Practice Address - Phone:217-876-6860
Practice Address - Fax:217-876-6868
Is Sole Proprietor?:No
Enumeration Date:2025-09-22
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.033276363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care