Provider Demographics
NPI:1164314811
Name:DESAUTEL THOMPSON, KATELYN MARY (DNP)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARY
Last Name:DESAUTEL THOMPSON
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-2239
Mailing Address - Country:US
Mailing Address - Phone:701-360-1649
Mailing Address - Fax:
Practice Address - Street 1:164 W 13TH ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1826
Practice Address - Country:US
Practice Address - Phone:701-352-1620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND202850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily