Provider Demographics
NPI:1245230010
Name:KILGORE, CATHERINE M (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:M
Last Name:KILGORE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:CATHERINE
Other - Middle Name:M
Other - Last Name:PALNAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:207 ADAMS DR
Mailing Address - Street 2:
Mailing Address - City:DEMOREST
Mailing Address - State:GA
Mailing Address - Zip Code:30535-4501
Mailing Address - Country:US
Mailing Address - Phone:706-754-5191
Mailing Address - Fax:706-754-1725
Practice Address - Street 1:207 ADAMS DR
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-4501
Practice Address - Country:US
Practice Address - Phone:706-754-5191
Practice Address - Fax:706-754-1725
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN089707NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q43539Medicare UPIN