Healthcare Provider Details

I. General information

NPI: 1588010185
Provider Name (Legal Business Name): MRS. KATASHA RAE FLATT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATASHA RAE BROWN NP

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8877 MENTOR AVE
MENTOR OH
44060-6211
US

IV. Provider business mailing address

169 MADISON AVE STE 38114
NEW YORK NY
10016-5101
US

V. Phone/Fax

Practice location:
  • Phone: 440-205-1225
  • Fax: 440-205-1275
Mailing address:
  • Phone: 646-876-8455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024196630
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26785
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0041789
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: