Individual provider · Type 1 NPI

Katie Ann Mattila, NP

Nurse Practitioner · Grand Rapids, MI

NPI number 1124891858 Active

Practice location

790 Fuller Ave NE
Grand Rapids, MI 49503-1918

Call (616) 336-3909 Map

Fax (616) 336-8830

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice locations

200 1st St SW, Rochester, MN 55905-0001 · (507) 284-2511
4820 23rd Ave S, Fargo, ND 58104-9137 · (469) 677-7430

Specialties and licenses

Taxonomy	Code	License
Psychiatric/Mental Health Nurse Practitioner	363LP0808X	204623 (ND)
Nurse Practitioner Primary	363L00000X	11177 (MN)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

400 other providers at this address

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About NPI 1124891858

Katie Ann Mattila, NP's National Provider Identifier is 1124891858, issued on Nov 3, 2023. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Grand Rapids, MI. The record was last updated on May 29, 2026.