Provider Demographics
NPI:1427886514
Name:KERN, KATELYN LORRAINE (DNP)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:LORRAINE
Last Name:KERN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7937 HOLLOWAY LN NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516-9109
Mailing Address - Country:US
Mailing Address - Phone:360-870-2761
Mailing Address - Fax:
Practice Address - Street 1:4254 JACKSON HWY
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-8424
Practice Address - Country:US
Practice Address - Phone:360-996-6603
Practice Address - Fax:360-996-6604
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP70038496363LF0000X
WARN61325585163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2343306Medicaid