Provider Demographics
NPI:1215133384
Name:GARLAND, KATRINA MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:MARIE
Last Name:GARLAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10881 US RTE 11
Mailing Address - Street 2:PO BOX 156
Mailing Address - City:ADAMS
Mailing Address - State:NY
Mailing Address - Zip Code:13605
Mailing Address - Country:US
Mailing Address - Phone:315-232-4400
Mailing Address - Fax:315-232-4455
Practice Address - Street 1:10881 US RTE 11
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:NY
Practice Address - Zip Code:13605
Practice Address - Country:US
Practice Address - Phone:315-232-4400
Practice Address - Fax:315-232-4455
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304725363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health