Provider Demographics
NPI:1235334780
Name:KOVACS, KATHARINE DENUES (PA)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:DENUES
Last Name:KOVACS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KITTY
Other - Middle Name:DENUES
Other - Last Name:KOVACS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1540 SUNDAY DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6000
Mailing Address - Country:US
Mailing Address - Phone:919-782-3456
Mailing Address - Fax:919-788-8519
Practice Address - Street 1:1540 SUNDAY DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6000
Practice Address - Country:US
Practice Address - Phone:919-782-3456
Practice Address - Fax:919-788-8519
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101611363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1235334780Medicare PIN