Provider Demographics
NPI:1952074551
Name:DAY, KATARINA MICHELLE
Entity Type:Individual
Prefix:
First Name:KATARINA
Middle Name:MICHELLE
Last Name:DAY
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 1:64 RIVER PARK WAY
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-1890
Mailing Address - Country:US
Mailing Address - Phone:352-697-2175
Mailing Address - Fax:
Practice Address - Street 1:100 GENEVIEVE CT STE A
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-4868
Practice Address - Country:US
Practice Address - Phone:770-486-1818
Practice Address - Fax:770-486-7303
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN281667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily