Provider Demographics
NPI:1225307192
Name:HORSLEY, KATHLENE JOY (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHLENE
Middle Name:JOY
Last Name:HORSLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:KATHLENE
Other - Middle Name:JOY
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:SINAI HOSPITAL, DEPARTMENT OF SURGERY
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215
Mailing Address - Country:US
Mailing Address - Phone:410-601-6025
Mailing Address - Fax:410-601-5835
Practice Address - Street 1:2401 W BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5216
Practice Address - Country:US
Practice Address - Phone:410-601-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-22
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004664363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant