Provider Demographics
NPI:1104428614
Name:FOGLE, KATHERINE MCGRATH (NP-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MCGRATH
Last Name:FOGLE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 JOHN PLATT DR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4389
Mailing Address - Country:US
Mailing Address - Phone:252-247-4297
Mailing Address - Fax:252-247-1620
Practice Address - Street 1:3511 JOHN PLATT DR
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4389
Practice Address - Country:US
Practice Address - Phone:252-247-4297
Practice Address - Fax:252-247-1620
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF10201163363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily