Provider Demographics
NPI:1902061906
Name:LOGEE, KATHERINE (FNP-BC, CPNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:LOGEE
Suffix:
Gender:F
Credentials:FNP-BC, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 CYMBELINE STREET
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1841 CYMBELINE ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-4974
Practice Address - Country:US
Practice Address - Phone:916-742-1944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-19
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008485363LF0000X
CA18533363LP0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics