Provider Demographics
NPI:1720636038
Name:SUTHERLAND, KATHERINE PRICE (FNP-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:PRICE
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:GLYNN
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 986513
Mailing Address - Street 2:DEPT 100
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02298-6513
Mailing Address - Country:US
Mailing Address - Phone:910-219-8326
Mailing Address - Fax:910-939-4269
Practice Address - Street 1:114A MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6328
Practice Address - Country:US
Practice Address - Phone:910-353-0700
Practice Address - Fax:910-353-5305
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178159363LF0000X
NC5014159363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily