MEDICARE: DR. KATRINA JOY AUGUSTIN MD

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	390200000X	Student in an Organized Health Care Education/Training Program	MD471463	PA
2	207P00000X	Emergency Medicine Physician	73632	MN

General Provider Information

NPI Number	:	1487142204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATRINA JOY AUGUSTIN MD

Provider Business Mailing Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-0002
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-2536
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

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

Provider Enumeration Date	:	04/26/2018
Last Update Date	:	07/13/2023

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