Provider Demographics
NPI:1972399590
Name:GOCAL, KATELYN (FNP)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:GOCAL
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9542 ANTIGO DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-7104
Mailing Address - Country:US
Mailing Address - Phone:618-971-9405
Mailing Address - Fax:
Practice Address - Street 1:1225 GRAHAM RD STE C-1350
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8022
Practice Address - Country:US
Practice Address - Phone:315-953-6690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025009746363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily