Provider Demographics
NPI:1093228900
Name:BARTON, KATELYN JO (NP)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:JO
Last Name:BARTON
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:JO
Other - Last Name:CARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:825 NICOLLET MALL STE 556
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-2603
Mailing Address - Country:US
Mailing Address - Phone:844-670-2273
Mailing Address - Fax:833-471-4119
Practice Address - Street 1:71 S FRONT ST
Practice Address - Street 2:
Practice Address - City:GRANT
Practice Address - State:MI
Practice Address - Zip Code:49327-9701
Practice Address - Country:US
Practice Address - Phone:844-537-1036
Practice Address - Fax:833-626-1945
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704294950363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner