Provider Demographics
NPI:1407539620
Name:MCLEOD, KATELIN CRISTINE (NP-C)
Entity Type:Individual
Prefix:
First Name:KATELIN
Middle Name:CRISTINE
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KATELIN
Other - Middle Name:
Other - Last Name:MCLEOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4535 BORING POND LN
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31606-1980
Mailing Address - Country:US
Mailing Address - Phone:229-269-3328
Mailing Address - Fax:
Practice Address - Street 1:2501 N PATTERSON ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1785
Practice Address - Country:US
Practice Address - Phone:229-433-1000
Practice Address - Fax:229-433-7999
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN279656363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily