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Individual

KATHLEEN MILLER BRANDENBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
601 E PORTERSVILLE RD, PORTERSVILLE, PA 16051-2119
(724) 601-3474
Mailing address
6388 MAZELLE TRL SW, OCEAN ISLE BEACH, NC 28469-5777
(910) 520-5127

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5012514
NC
363LF0000X
Family Nurse Practitioner
SP007684
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SP007684
LICENSE
PA
Enumeration date
07/20/2006
Last updated
02/21/2024
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