Provider Demographics
NPI:1154602431
Name:BROWN, KATIE MELISSA KAYE (PA)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:MELISSA KAYE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:TURRIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PAC
Mailing Address - Street 1:400 13TH AVE S STE 206
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4300
Mailing Address - Country:US
Mailing Address - Phone:406-731-8888
Mailing Address - Fax:406-731-8318
Practice Address - Street 1:400 13TH AVE S STE 206
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4300
Practice Address - Country:US
Practice Address - Phone:406-731-8888
Practice Address - Fax:406-731-8318
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
MT663363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant