MEDICARE: MICHAEL D KATONA NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	4704280087	MI

General Provider Information

NPI Number	:	1174043889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D KATONA NP

Provider Business Mailing Address
First Line	:	3860 S STRAITS HWY
Second Line	:
City	:	INDIAN RIVER
State	:	MI
Zip	:	49749-5146
Country	:	US
Telephone Number	:	231-238-0581
Fax Number	:	989-731-7929

Provider Business Practice Location Address
First Line	:	3860 S STRAITS HWY
Second Line	:
City	:	INDIAN RIVER
State	:	MI
Zip	:	49749-5146
Country	:	US
Telephone Number	:	231-238-0581
Fax Number	:	989-731-7929

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2017
Last Update Date	:	08/01/2024

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