| Doctor Name: | KATINA BRISCOE |
| NPI Number: | 1023170305 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 3007796 |
| Business Practice Address: | 125 Oak Street Cotton Plant, AR - 72036 |
| Business Phone Number: | 8704593588 |
| Business Fax Number: | 8703473492 |
| Mailing Address: | Po Box 497, AUGUSTA |
| State: | AR |
| Postal Code: | 720060497 |
| Phone Number: | 8703473350 |
| Fax Number: | 8703473492 |
| NPI Enumeration Date: | 12/14/2006 |
| NPI Last Update Date: | 11/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 3007796 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |