Provider Demographics
NPI:1942491410
Name:KOCHANOWSKY, KATHIE LYNN (RN, ANP-C)
Entity Type:Individual
Prefix:MS
First Name:KATHIE
Middle Name:LYNN
Last Name:KOCHANOWSKY
Suffix:
Gender:F
Credentials:RN, ANP-C
Other - Prefix:MS
Other - First Name:KATHIE
Other - Middle Name:LYNN
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:9191 PINECROFT DR
Mailing Address - Street 2:SUITE 245
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2796
Mailing Address - Country:US
Mailing Address - Phone:281-363-2277
Mailing Address - Fax:281-419-3377
Practice Address - Street 1:9191 PINECROFT DR
Practice Address - Street 2:SUITE 245
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-2796
Practice Address - Country:US
Practice Address - Phone:281-363-2277
Practice Address - Fax:281-419-3377
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX430264363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health