Individual
DR. KATHERINE JEAN COULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP,APN,FNP-BC,MSN
Contact information
Practice address
380 E IL ROUTE 38, ROCHELLE, IL 61068-9694
(779) 696-9050
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209009522
IL
363L00000X
Nurse Practitioner
Primary
277-000567
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL5966012
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
05/01/2012
Last updated
03/03/2021
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