Provider Demographics
NPI:1457754467
Name:BRIGHAM, KATHLYN MORGAN (RN, MS, CRNP)
Entity Type:Individual
Prefix:
First Name:KATHLYN
Middle Name:MORGAN
Last Name:BRIGHAM
Suffix:
Gender:F
Credentials:RN, MS, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22936 CATTAIL LN
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:MD
Mailing Address - Zip Code:20619-4004
Mailing Address - Country:US
Mailing Address - Phone:301-862-5344
Mailing Address - Fax:
Practice Address - Street 1:22936 CATTAIL LN
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:MD
Practice Address - Zip Code:20619-4004
Practice Address - Country:US
Practice Address - Phone:301-862-5344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-04
Last Update Date:2014-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO63212363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics