# KLA J BROSIUS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1043620669
- **Gender:** Man
- **Credential:** CRNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | RN703306 | PA | — |
| 363L00000X | Nurse Practitioner | SP022125 | PA | — |
| 363LF0000X | Family Nurse Practitioner | SP022125 | PA | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | SP029731 | PA | Yes |

## Other

- **Enumeration date:** 05/05/2014
- **Last updated:** 12/05/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 103802749 | — | PA |
| 01 | — | 1043620669 | NPI | — |
| 01 | — | 14672457 | CAQH | PA |