Provider Demographics
NPI:1790034858
Name:BRUMLEY, KATHRYN ROSE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ROSE
Last Name:BRUMLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31007 INTERSTATE 10 W STE 115
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-9265
Mailing Address - Country:US
Mailing Address - Phone:830-981-9540
Mailing Address - Fax:
Practice Address - Street 1:31007 INTERSTATE 10 W STE 115
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-9265
Practice Address - Country:US
Practice Address - Phone:830-981-9540
Practice Address - Fax:210-490-6758
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP122606363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily