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Individual
KLA J BROSIUS
Active
Individual
KLA J BROSIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN703306
PA
363L00000X
Nurse Practitioner
SP022125
PA
363LF0000X
Family Nurse Practitioner
SP022125
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP029731
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103802749
—
PA
01
—
1043620669
NPI
—
01
—
14672457
CAQH
PA
Enumeration date
05/05/2014
Last updated
12/05/2025
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