Healthcare Provider Details

I. General information

NPI: 1780207662
Provider Name (Legal Business Name): KATIE MOHLMAN APRN-C, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATIE HARRISON

II. Dates (important events)

Enumeration Date: 05/26/2020
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 W. POPLAR
ROGERS AR
72756
US

IV. Provider business mailing address

4401 W 109TH ST STE 200
OVERLAND PARK KS
66211-1303
US

V. Phone/Fax

Practice location:
  • Phone: 479-337-5307
  • Fax: 479-337-5302
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number121950
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number124520
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: