Provider Demographics
NPI:1396395604
Name:GOULD, KATHARINE PERRY (APRN)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:PERRY
Last Name:GOULD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:MCNEILL
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:55 DAMONTE RANCH PKWY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-2996
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 DAMONTE RANCH PKWY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-2996
Practice Address - Country:US
Practice Address - Phone:775-852-9304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV812050363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily