Provider Demographics
NPI:1235168972
Name:O'ROURKE, KATHERINE MAE (ARNP,C)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:MAE
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:ARNP,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 TORTOISE VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3801
Mailing Address - Country:US
Mailing Address - Phone:321-795-5492
Mailing Address - Fax:321-402-9322
Practice Address - Street 1:2900 VETERANS WAY
Practice Address - Street 2:HOME BASED PRIMARY CARE
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940
Practice Address - Country:US
Practice Address - Phone:321-795-5492
Practice Address - Fax:321-637-3605
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1010832363LF0000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology