Nurse Practitioner
KATIE MATTILA NP
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1124891858 · enumerated 2023-11-03 · record updated 2026-05-29. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Other names: KATIE LONGENECKER
Addresses and phones
- Mailing address PO BOX 5074, SIOUX FALLS, SD, 57117-5074 Google Maps Apple Maps OpenStreetMap
- Practice location 790 FULLER AVE NE, GRAND RAPIDS, MI, 49503-1918 (616) 336-3909 Fax (616) 336-8830 Google Maps Apple Maps OpenStreetMap
Specialties
- Nurse Practitioner, Psych/Mental Health 363LP0808X · License 204623 ND
- Nurse Practitioner 363L00000X · Primary · License 11177 MN
In this directory
Locations and evidence
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Practice location
GRAND RAPIDS, MI, 495031918
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.