Healthcare Provider Details

I. General information

NPI: 1629314836
Provider Name (Legal Business Name): KATHERINE WILLETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHERINE WILLETT DAHLBERG MD

II. Dates (important events)

Enumeration Date: 12/14/2012
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4031 LA GRANDE PRINCESSE UNIT 47
CHRISTIANSTED VI
00820
US

IV. Provider business mailing address

4031 LA GRANDE PRINCESSE UNIT 47
CHRISTIANSTED VI
00820
US

V. Phone/Fax

Practice location:
  • Phone: 340-422-4220
  • Fax: 844-973-1338
Mailing address:
  • Phone: 340-422-4220
  • Fax: 844-973-1338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number3297
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: