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General NPI Number Information
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NPI Number | 1851018345
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Entity Type | Individual
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Provider Name | KATELYN BROOKE MCDONALD PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/25/2022
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 413 W ROBERTSON ST STE B
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City | BRANDON
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State | FL
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Zip | 33511-5014
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Country | US
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Telephone | 813-999-1516
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Fax | 813-441-8519
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Provider Business Mailing Address
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Address Line | 413 W ROBERTSON ST STE B
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City | BRANDON
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State | FL
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Zip | 33511-5014
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Country | US
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Telephone | 814-999-1516
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11022664
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License Number State | FL
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