Healthcare Provider Details

I. General information

NPI: 1689669848
Provider Name (Legal Business Name): KATHERINE HOULE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 W FAIR AVE STE 344
MARQUETTE MI
49855-2675
US

IV. Provider business mailing address

PO BOX 220
MARQUETTE MI
49855-0220
US

V. Phone/Fax

Practice location:
  • Phone: 906-225-3910
  • Fax:
Mailing address:
  • Phone: 906-225-3910
  • Fax: 906-225-4529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number142962
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: