Provider Demographics
NPI:1477953438
Name:MOFFITT, KATHERINE KAISER (PT, DPT, LAT, ATC)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:KAISER
Last Name:MOFFITT
Suffix:
Gender:F
Credentials:PT, DPT, LAT, ATC
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:KAISER
Other - Last Name:MOFFITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT, LAT, ATC
Mailing Address - Street 1:3001 EDWARDS MILL RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5243
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3001 EDWARDS MILL RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5243
Practice Address - Country:US
Practice Address - Phone:919-863-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18472255A2300X
NCP20973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer