Provider Demographics
NPI:1437145307
Name:RATKOVICH, KATY R (MPA, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATY
Middle Name:R
Last Name:RATKOVICH
Suffix:
Gender:F
Credentials:MPA, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1002 WHISPERING WOODS DR
Mailing Address - Street 2:
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-9033
Mailing Address - Country:US
Mailing Address - Phone:724-779-2010
Mailing Address - Fax:
Practice Address - Street 1:301 SMITH DR
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-4131
Practice Address - Country:US
Practice Address - Phone:724-779-2010
Practice Address - Fax:724-779-2011
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA003164L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical