Provider Demographics
NPI:1407538465
Name:BOYER, KATHERINE MEGAN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:MEGAN
Last Name:BOYER
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 1:1060 N CAPITOL AVE STE 3-101
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1044
Mailing Address - Country:US
Mailing Address - Phone:317-410-6109
Mailing Address - Fax:
Practice Address - Street 1:1060 N CAPITOL AVE STE 3-101
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1044
Practice Address - Country:US
Practice Address - Phone:317-410-6109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN10004132AOtherSTATE LICENSE