Provider Demographics
NPI:1932863941
Name:ANDERSON, KATRINA OLLIE
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:OLLIE
Last Name:ANDERSON
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 1:3938 MARTINS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-2139
Mailing Address - Country:US
Mailing Address - Phone:828-360-5884
Mailing Address - Fax:
Practice Address - Street 1:3938 MARTINS CREEK RD
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-2139
Practice Address - Country:US
Practice Address - Phone:828-360-5884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC205597163W00000X
NC5015391363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse