Provider Demographics
NPI:1336456656
Name:KATORSKI, JENNA R (RN CNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:R
Last Name:KATORSKI
Suffix:
Gender:F
Credentials:RN CNP
Other - Prefix:
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Mailing Address - Street 1:435 PHALEN BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55130-5302
Mailing Address - Country:US
Mailing Address - Phone:651-636-9443
Mailing Address - Fax:651-638-4744
Practice Address - Street 1:435 PHALEN BLVD
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-5302
Practice Address - Country:US
Practice Address - Phone:651-636-9443
Practice Address - Fax:651-638-4744
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR-174036-9363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily