Provider Demographics
NPI:1760614002
Name:BRANSBY, KRISTEN ANN (DNP, CPNP-PC, PMHS)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANN
Last Name:BRANSBY
Suffix:
Gender:F
Credentials:DNP, CPNP-PC, PMHS
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ANN DANESE
Other - Last Name:ALTDOERFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2985 TIFFANY DR
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-8306
Mailing Address - Country:US
Mailing Address - Phone:610-235-9555
Mailing Address - Fax:
Practice Address - Street 1:2985 TIFFANY DR
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-8306
Practice Address - Country:US
Practice Address - Phone:610-235-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASPO129022080P0006X
PASP012902363LP0808X, 363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70593FMedicaid
CAFHC71031FMedicaid
CA551903Medicare Oscar/Certification
CAW1508EMedicare PIN
CAFHC71031FMedicaid
CAW1508AMedicare PIN