Provider Demographics
NPI:1033540067
Name:KINLEY, KATIE (PA)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:
Last Name:KINLEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 DELAFIELD RD
Mailing Address - Street 2:200 MEDICAL ARTS BUILDING SUITE 2040
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3205
Mailing Address - Country:US
Mailing Address - Phone:412-784-5888
Mailing Address - Fax:412-784-5281
Practice Address - Street 1:200 DELAFIELD RD
Practice Address - Street 2:200 MEDICAL ARTS BUILDING SUITE 2040
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3205
Practice Address - Country:US
Practice Address - Phone:412-784-5888
Practice Address - Fax:412-784-5281
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056373363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical