Individual provider · NPI-1

Katrina Marie Brockway, RN

Registered Nurse, Registered Nurse First Assistant · Tampa, FL

NPI number1154696201

StatusActive

Last updated in NPPESMar 21, 2012

Details

NPI: 1154696201
Entity type: Individual (NPI-1)
Name: Katrina Marie Brockway
Credential: RN
Sex: Female
Sole proprietor: No
Enumeration date: Mar 21, 2012
Last updated: Mar 21, 2012

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
163WR0006X	Registered Nurse, Registered Nurse First Assistant	R158571	MD	Yes

Practice location

12880 Commodity Pl
Tampa, FL 33626-3101

Phone 813-865-1340 · Fax 813-343-5506

Mailing address

12880 Commodity Pl
Tampa, FL 33626-3101

Phone 813-865-1340 · Fax 813-343-5506

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