Provider Demographics
NPI:1780207662
Name:MOHLMAN, KATIE (APRN-C, WHNP)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:MOHLMAN
Suffix:
Gender:F
Credentials:APRN-C, WHNP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4401 W 109TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1222 W. POPLAR
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756
Practice Address - Country:US
Practice Address - Phone:479-337-5307
Practice Address - Fax:479-337-5302
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK121950367A00000X
AR124520367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife