Basic Information
| Provider Information | |||||||||
| NPI: | 1801212709 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MANN | ||||||||
| FirstName: | KATHERINE | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3181 COUNTY ROAD 1141 | ||||||||
| Address2: | |||||||||
| City: | CULLMAN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350576620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2563388767 | ||||||||
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| Practice Location | |||||||||
| Address1: | 408 CLARK ST NE | ||||||||
| Address2: | |||||||||
| City: | CULLMAN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350551953 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567394131 | ||||||||
| FaxNumber: | 2567365185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2014 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 1-130749 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.