Provider Demographics
NPI:1407918386
Name:ZLATARIC, KATRINA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:ZLATARIC
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7141 METROPOLITAN BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:BARNHART
Mailing Address - State:MO
Mailing Address - Zip Code:63012-2604
Mailing Address - Country:US
Mailing Address - Phone:636-352-2346
Mailing Address - Fax:314-690-4002
Practice Address - Street 1:7141 METROPOLITAN BLVD STE 103
Practice Address - Street 2:
Practice Address - City:BARNHART
Practice Address - State:MO
Practice Address - Zip Code:63012-2604
Practice Address - Country:US
Practice Address - Phone:636-352-2346
Practice Address - Fax:314-690-4002
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO141987363LP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO427230503Medicaid
MO141987OtherSTATE LICENSE