Provider Demographics
NPI:1154865251
Name:JARRIN, KATASHA (FNP)
Entity type:Individual
Prefix:
First Name:KATASHA
Middle Name:
Last Name:JARRIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KATASHA
Other - Middle Name:
Other - Last Name:JARRIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:2529 RAEFORD RD STE A
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5483
Mailing Address - Country:US
Mailing Address - Phone:910-703-7097
Mailing Address - Fax:910-637-6083
Practice Address - Street 1:2529 RAEFORD RD STE A
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5483
Practice Address - Country:US
Practice Address - Phone:910-703-7097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-07
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009144363LF0000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry