Provider Demographics
NPI:1447515739
Name:HERRERA, KATIE LYNN (ARNP/CNM)
Entity type:Individual
Prefix:MS
First Name:KATIE
Middle Name:LYNN
Last Name:HERRERA
Suffix:
Gender:F
Credentials:ARNP/CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5802 CITRUS VILLAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5896
Mailing Address - Country:US
Mailing Address - Phone:407-696-2496
Mailing Address - Fax:407-209-0229
Practice Address - Street 1:5802 CITRUS VILLAGE BLVD
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5896
Practice Address - Country:US
Practice Address - Phone:407-696-2496
Practice Address - Fax:407-209-0229
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9280963367A00000X
FLMH4565896363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007386000Medicaid
FLHW208ZMedicare PIN