Provider Demographics
NPI:1174562359
Name:WILLETT GOEHRING, KATHERINE J (CFNP)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:J
Last Name:WILLETT GOEHRING
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:J
Other - Last Name:GOEHRING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:KATHERINE J WILLETT
Mailing Address - Street 1:7111 E BELL RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5638
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:
Practice Address - Street 1:7111 E BELL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5638
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP0471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ581977Medicaid
AZ581977Medicaid
63968Medicare ID - Type Unspecified