Healthcare Provider Details

I. General information

NPI: 1568387926
Provider Name (Legal Business Name): KRISTIN NICOLE KATICH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4120 SW 106TH PL
OCALA FL
34476-4238
US

IV. Provider business mailing address

4120 SW 106TH PL
OCALA FL
34476-4238
US

V. Phone/Fax

Practice location:
  • Phone: 352-362-3009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11050002
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: