Provider Demographics
NPI:1851811327
Name:ERNST, KATIE LYNN (APRN, DNP)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNN
Last Name:ERNST
Suffix:
Gender:F
Credentials:APRN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 FOXFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-9524
Mailing Address - Country:US
Mailing Address - Phone:907-491-0894
Mailing Address - Fax:
Practice Address - Street 1:21800 MARKET PL NW STE 103
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6667
Practice Address - Country:US
Practice Address - Phone:360-291-5700
Practice Address - Fax:360-637-0863
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60905096363LF0000X
AK123192363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily