Provider Demographics
NPI:1760614002
Name:BRANSBY, KRISTEN ANN (DNP, CPNP-PC, PMHS)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ANN
Last Name:BRANSBY
Suffix:
Gender:F
Credentials:DNP, CPNP-PC, PMHS
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ANN DANESE
Other - Last Name:ALTDOERFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1540 EDEN RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-5258
Mailing Address - Country:US
Mailing Address - Phone:610-235-9555
Mailing Address - Fax:610-544-1410
Practice Address - Street 1:1540 EDEN RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-5258
Practice Address - Country:US
Practice Address - Phone:610-235-9555
Practice Address - Fax:610-544-1410
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012902363LP0808X, 363LP0200X, 363LP0200X
PASPO129022080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC71031FMedicaid
CAFHC70593FMedicaid
CA551903Medicare Oscar/Certification
CAW1508EMedicare PIN
CAFHC71031FMedicaid
CAW1508AMedicare PIN