Provider Demographics
NPI:1306585351
Name:WESTBROOK, KATORIA L (DNP, APRN, AGPCNP-BC)
Entity type:Individual
Prefix:DR
First Name:KATORIA
Middle Name:L
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:DNP, APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3354 CAMERON CHASE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-2872
Mailing Address - Country:US
Mailing Address - Phone:850-345-9522
Mailing Address - Fax:
Practice Address - Street 1:3354 CAMERON CHASE DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-2872
Practice Address - Country:US
Practice Address - Phone:850-345-9522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-28
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9295981163WI0500X, 163WW0000X, 163WC1600X
FLAPRN11023037363LA2200X, 363LP2300X
FL11023037363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116334900Medicaid