Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Katelyn Bouthillier

Individual provider Physician Assistant · NPI 1760205264

Katelyn Bouthillier is a Physician Assistant in Monroe, North Carolina. Qualified in 2025, 1 year ago. Licensed in North Carolina.

Years since qualifying
1
Licensed in
NC
In the registry since
2024
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Practice location Address checks out

404 S Sutherland Ave
Monroe, NC 28112-5060
Phone: (704) 291-9267
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1760205264 (NC)

Record details

NPI number1760205264
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 4, 2024
Last updated in NPPESMay 11, 2026
Certification dateMay 11, 2026
Mailing address404 S Sutherland Ave, Monroe, NC 28112-5060

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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