| Doctor Name: | KATHLEEN MARIE PAWLANTA |
| NPI Number: | 1225055833 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | F.N.P. |
| License Number: | 4704196460 |
| Business Practice Address: | 829 N Center Ave Suite 210 Gaylord, MI - 497351595 |
| Business Phone Number: | 9897317860 |
| Business Fax Number: | 9897317954 |
| Mailing Address: | 829 N Center Ave, Suite 298 GAYLORD |
| State: | MI |
| Postal Code: | 497351595 |
| Phone Number: | 9897317708 |
| Fax Number: | 9897317929 |
| NPI Enumeration Date: | 07/17/2006 |
| NPI Last Update Date: | 12/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4704196460 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |