Provider Demographics
NPI:1265043020
Name:AGOSTA, KATLYN MEGAN (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KATLYN
Middle Name:MEGAN
Last Name:AGOSTA
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:KATLYN
Other - Middle Name:MEGAN
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33601-1289
Mailing Address - Country:US
Mailing Address - Phone:813-844-7500
Mailing Address - Fax:813-844-1141
Practice Address - Street 1:6488 N US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-1804
Practice Address - Country:US
Practice Address - Phone:813-844-7500
Practice Address - Fax:813-844-1141
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029713363LF0000X
TX1006634363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily