Provider Demographics
NPI:1992227847
Name:ALDRIDGE, KATHRYN ANN (MSN, PNP-PC)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ANN
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:MSN, PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 MUELLER BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3079
Mailing Address - Country:US
Mailing Address - Phone:512-777-2917
Mailing Address - Fax:
Practice Address - Street 1:12608 TERRA NOVA LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727
Practice Address - Country:US
Practice Address - Phone:661-877-6552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX782371163W00000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse