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General NPI Number Information
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NPI Number | 1760462212
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Entity Type | Individual
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Provider Name | CHRISTOPHER JASON KATAKOWSKI CRNP
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Gender | Male
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 1050 SE MONTEREY RD STE 400
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City | STUART
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State | FL
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Zip | 34994-4512
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Country | US
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Telephone | 772-288-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 SE MONTEREY RD STE 400
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City | STUART
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State | FL
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Zip | 34994-4512
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Country | US
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Telephone | 772-288-2400
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Fax | 772-237-0981
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP008792
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN9459055
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License Number State | FL
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