Provider Demographics
NPI:1508428939
Name:KROB, KATHERINE GRACE (APN, WHNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:GRACE
Last Name:KROB
Suffix:
Gender:F
Credentials:APN, WHNP
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:GRACE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 14000
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4033
Mailing Address - Country:US
Mailing Address - Phone:773-435-9036
Mailing Address - Fax:
Practice Address - Street 1:1455 N MILWAUKEE AVE FL 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2015
Practice Address - Country:US
Practice Address - Phone:773-435-9036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019290363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health