Provider Demographics
NPI:1295514073
Name:KATSAP, MAKENZIE MARIE (APRN)
Entity type:Individual
Prefix:
First Name:MAKENZIE
Middle Name:MARIE
Last Name:KATSAP
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8352 BEDAOS DR
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-7585
Mailing Address - Country:US
Mailing Address - Phone:330-540-8828
Mailing Address - Fax:
Practice Address - Street 1:7005 S EDGERTON RD
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-4203
Practice Address - Country:US
Practice Address - Phone:330-540-8828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0034959363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily