Provider Demographics
NPI:1316389927
Name:BOOKER, CATHERINE BICKEL (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:BICKEL
Last Name:BOOKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 DAYFLOWER ST
Mailing Address - Street 2:STE. 101
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-7585
Mailing Address - Country:US
Mailing Address - Phone:502-326-8588
Mailing Address - Fax:502-326-8589
Practice Address - Street 1:9301 DAYFLOWER ST
Practice Address - Street 2:STE. 101
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-7585
Practice Address - Country:US
Practice Address - Phone:502-326-8588
Practice Address - Fax:502-326-8589
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA1805363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000835340OtherANTHEM
KY000000835340OtherANTHEM
KYK100491Medicare PIN