Provider Demographics
NPI:1417558172
Name:FILS-AIME, KATRINA ANN
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:ANN
Last Name:FILS-AIME
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 1:15275 COLLIER BLVD # 201-145
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-6750
Mailing Address - Country:US
Mailing Address - Phone:800-757-3802
Mailing Address - Fax:239-384-9605
Practice Address - Street 1:501 GOODLETTE-FRANK RD N STE D100
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5666
Practice Address - Country:US
Practice Address - Phone:800-757-3802
Practice Address - Fax:239-384-9605
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-07
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL236878376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker