Provider Demographics
NPI:1487797726
Name:KATRINCHAK, CAROLYN MICHELLE (CNP)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MICHELLE
Last Name:KATRINCHAK
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 CUMBERLAND CT
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-7389
Mailing Address - Country:US
Mailing Address - Phone:440-365-4522
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE, RC25
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195
Practice Address - Country:US
Practice Address - Phone:440-989-4874
Practice Address - Fax:440-989-4878
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-08980363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health