Provider Demographics
NPI:1508535063
Name:BROWN, KATIE JO (FNP)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:JO
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:JO
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:7950 E MISSISSIPPI AVE STE C
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-2151
Mailing Address - Country:US
Mailing Address - Phone:630-797-8614
Mailing Address - Fax:
Practice Address - Street 1:7950 E MISSISSIPPI AVE STE C
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-2151
Practice Address - Country:US
Practice Address - Phone:303-353-1440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1692767163W00000X
TN240683163W00000X
TN30293363LF0000X
COAPN.0999197363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse