Provider Demographics
NPI:1407565716
Name:PARKINS, KATIE LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNN
Last Name:PARKINS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:LYNN
Other - Last Name:BARAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1207 N AUGUSTA LN
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:WA
Mailing Address - Zip Code:99006-3400
Mailing Address - Country:US
Mailing Address - Phone:509-290-9512
Mailing Address - Fax:
Practice Address - Street 1:509 E MAIN AVE
Practice Address - Street 2:
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109-8964
Practice Address - Country:US
Practice Address - Phone:509-935-6001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61377905363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily