Provider Demographics
NPI:1508103110
Name:RINELL, KATELYN A (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:A
Last Name:RINELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:KATELYN
Other - Middle Name:M
Other - Last Name:ASBILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2005 ROBIN RD
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-4618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1305 N ELM ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2783
Practice Address - Country:US
Practice Address - Phone:270-827-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA1802363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000819336OtherANTHEM BC/BS
KY950064OtherWELLCARE OF KY
KY7100274030Medicaid
KY7100274030Medicaid