Provider Demographics
NPI:1477903565
Name:BROWN, KATE M (CRNP)
Entity Type:Individual
Prefix:MS
First Name:KATE
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:M
Other - Last Name:LIGHTFOOT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:21 WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-8268
Mailing Address - Country:US
Mailing Address - Phone:717-591-3630
Mailing Address - Fax:717-591-3631
Practice Address - Street 1:21 WATERFORD DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-8268
Practice Address - Country:US
Practice Address - Phone:717-591-3630
Practice Address - Fax:717-591-3631
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016360363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103123508Medicaid