Provider Demographics
NPI:1013723089
Name:LOSENNO, KATIE LYNN (MD, FRCPC, MSC)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:LYNN
Last Name:LOSENNO
Suffix:
Gender:F
Credentials:MD, FRCPC, MSC
Other - Prefix:
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Mailing Address - Street 1:505 ZEPHYR ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-5183
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4910 MUELLER BLVD # 102
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3079
Practice Address - Country:US
Practice Address - Phone:512-844-3714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX482602080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology