Provider Demographics
NPI:1316696628
Name:GUIMARIN, KATHERINE WOOLF (NP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:WOOLF
Last Name:GUIMARIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:WOOLF
Other - Last Name:GUIMARIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:107 GOVERNORS DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4326
Mailing Address - Country:US
Mailing Address - Phone:256-535-2300
Mailing Address - Fax:
Practice Address - Street 1:107 GOVERNORS DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4326
Practice Address - Country:US
Practice Address - Phone:256-535-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-140467363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily