Healthcare Provider Details

I. General information

NPI: 1124533872
Provider Name (Legal Business Name): KATIE JEAN ALLEN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE JEAN ERICHSEN ARNP

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981 LITTON LN
BLACKSBURG VA
24060-6340
US

IV. Provider business mailing address

213 S JEFFERSON ST STE 1006
ROANOKE VA
24011-1713
US

V. Phone/Fax

Practice location:
  • Phone: 540-558-2400
  • Fax: 540-953-5024
Mailing address:
  • Phone: 540-224-5372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60804361
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024180442
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: