Provider Demographics
NPI:1588837678
Name:BREITSPRECHER, KATHY L (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:L
Last Name:BREITSPRECHER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:L
Other - Last Name:HAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6511 US HIGHWAY 181 N.
Mailing Address - Street 2:
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114
Mailing Address - Country:US
Mailing Address - Phone:830-393-1760
Mailing Address - Fax:830-393-1762
Practice Address - Street 1:6511 US HIGHWAY 181 N
Practice Address - Street 2:
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114
Practice Address - Country:US
Practice Address - Phone:830-393-1760
Practice Address - Fax:830-393-1762
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17672363LP0200X
TXAP112622363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics