Provider Demographics
NPI:1346326329
Name:PORTERFIELD, KATHERINE SHARP (PA-C)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SHARP
Last Name:PORTERFIELD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9525 DONA ROWENA AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2509
Mailing Address - Country:US
Mailing Address - Phone:505-554-1208
Mailing Address - Fax:
Practice Address - Street 1:9525 DONA ROWENA AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2509
Practice Address - Country:US
Practice Address - Phone:505-554-1208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051235363A00000X
NMPA2011-0054363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant