Provider Demographics
NPI:1720863186
Name:LEPAR, KATHERINE (DNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:LEPAR
Suffix:
Gender:
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 E OLANTA
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-1344
Mailing Address - Country:US
Mailing Address - Phone:248-622-9383
Mailing Address - Fax:
Practice Address - Street 1:39425 GARFIELD RD STE 24
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-4651
Practice Address - Country:US
Practice Address - Phone:586-649-3181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704327015363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily