Healthcare Provider Details

I. General information

NPI: 1902408891
Provider Name (Legal Business Name): KATHERINE GETTY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2020
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 STATE ST FL 4
ERIE PA
16507-1427
US

IV. Provider business mailing address

300 STATE ST STE 401
ERIE PA
16507-1438
US

V. Phone/Fax

Practice location:
  • Phone: 914-877-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP022799
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP022799
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN671170
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: