Provider Demographics
NPI:1023386356
Name:PITHAN, KATE (PA-C)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:PITHAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:EISCHEID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12493 UNIVERSITY AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8286
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12493 UNIVERSITY AVE STE 110
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8286
Practice Address - Country:US
Practice Address - Phone:515-358-9400
Practice Address - Fax:515-358-9420
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA078423363A00000X
KS15-01165363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant