| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KATIE MARIE GAUTHIER | 1417734732 | 2023-09-11 |
Katie Marie Gauthier is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1417734732. Registration indicates Katie Marie Gauthier is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Katie Marie Gauthier PA-C |
| Practice Office Address | 5701 BOW POINTE DR STE 370 CLARKSTON, MI US |
| Practice Office Telephone | 2486254055 |
| Mailing Address | 5701 BOW POINTE DR STE 370 CLARKSTON, MI 483465403 US |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers |