Provider Demographics
NPI:1538942990
Name:BRANDYBERRY, KATHARINE ELIZABETH NOON (CRNP)
Entity type:Individual
Prefix:MS
First Name:KATHARINE
Middle Name:ELIZABETH NOON
Last Name:BRANDYBERRY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 PLEASURE RD
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-2686
Mailing Address - Country:US
Mailing Address - Phone:717-368-8191
Mailing Address - Fax:
Practice Address - Street 1:676 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:17557-1426
Practice Address - Country:US
Practice Address - Phone:717-354-4671
Practice Address - Fax:717-354-2478
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028052363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily