Provider Demographics
NPI:1699849752
Name:ENGLAND, KATHERINE A (FNP-C)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:ENGLAND
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:2134 HAMPTON PL
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3691
Mailing Address - Country:US
Mailing Address - Phone:517-347-3000
Mailing Address - Fax:517-347-8393
Practice Address - Street 1:2134 HAMPTON PL
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3691
Practice Address - Country:US
Practice Address - Phone:517-347-3000
Practice Address - Fax:517-347-8393
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704226521363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P27070018Medicare PIN