Provider Demographics
NPI:1902793672
Name:DE SOUZA, KATHERINE ASHLEY (DNP, APRN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ASHLEY
Last Name:DE SOUZA
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ASHLEY
Other - Last Name:GANZHORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3832 GRAND CENTRAL PL W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-7638
Mailing Address - Country:US
Mailing Address - Phone:904-518-2076
Mailing Address - Fax:
Practice Address - Street 1:3832 GRAND CENTRAL PL W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-7638
Practice Address - Country:US
Practice Address - Phone:904-518-2076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11035536363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily