Provider Demographics
NPI:1679145320
Name:BROWNE, KATHERINE BENNETT (PA-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:BENNETT
Last Name:BROWNE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 NANCY ST NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1334
Mailing Address - Country:US
Mailing Address - Phone:770-423-0395
Mailing Address - Fax:
Practice Address - Street 1:590 NANCY ST NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1334
Practice Address - Country:US
Practice Address - Phone:770-423-0395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA103872086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty