Provider Demographics
NPI:1063274736
Name:GOLINSKE, KATHERINE CECILIA
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CECILIA
Last Name:GOLINSKE
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 1:16433 PARKLANE ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-2122
Mailing Address - Country:US
Mailing Address - Phone:734-679-3867
Mailing Address - Fax:
Practice Address - Street 1:16433 PARKLANE ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-2122
Practice Address - Country:US
Practice Address - Phone:734-679-3867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant