Provider Demographics
NPI:1972488641
Name:TARLETON, KATIE ANN
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:ANN
Last Name:TARLETON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:ANN
Other - Last Name:MCFADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3949 W WEST SALEM RD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:OH
Mailing Address - Zip Code:44214-9788
Mailing Address - Country:US
Mailing Address - Phone:330-464-6190
Mailing Address - Fax:
Practice Address - Street 1:4634 HILLS AND DALES RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1510
Practice Address - Country:US
Practice Address - Phone:330-477-0255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0039491363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily