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

Katrina Daisy Mansour

Individual provider Physician Assistant · NPI 1396609715

Katrina Daisy Mansour is a Physician Assistant in Flint, Michigan. Qualified in 2025, 1 year ago. Practices with Dermatology and Cosmetic Center PLLC, a 9-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
1
Licensed in
MI
In the registry since
2025

Practice location Address checks out

4444 W Bristol Rd Ste 150
Flint, MI 48507-3161
Phone: (833) 322-3376
Fax: (248) 607-6777
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (MI)

Record details

NPI number1396609715
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 10, 2025
Last updated in NPPESApril 5, 2026
Certification dateApril 5, 2026
Mailing address4444 W Bristol Rd Ste 150, Flint, MI 48507-3161

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)
Group practice Dermatology And Cosmetic Center Pllc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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