KATELYN C GUSTAFSON

NORTON SHORES, MI
NPI1912454455
Former NameKATELYN C SMITH
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: MI  4704373177)
Additional Taxonomies363LP2300X Nurse Practitioner, Primary Care
(Licence: NC  5008868)
363LX0001X Nurse Practitioner, Obstetrics & Gynecology
(Licence: IN  71013513A)
Enumeration Date2016-09-01
Last Update Date2023-01-25
Business Address
KATELYN C GUSTAFSON NP
6401 PRAIRIE ST STE 1700
NORTON SHORES, MI 49444-7843
Phone number: 231-727-7944
Mailing Address
KATELYN C GUSTAFSON NP
250 N SHADELAND AVE
INDIANAPOLIS, IN 46219-4959
Phone number: