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

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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