Individual
KATHRYN MAE GILREATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7333 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6280
(260) 458-3830
Mailing address
371 TREMONT CIR, VALPARAISO, IN 46385-8074
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN144662
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
2822617A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300001584
—
IN
Enumeration date
08/27/2006
Last updated
09/16/2020
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