Provider Demographics
NPI:1538314794
Name:SMITH, KATI JEANNINE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATI
Middle Name:JEANNINE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:310 ELECTRIC AVE
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1369
Practice Address - Country:US
Practice Address - Phone:717-242-8124
Practice Address - Fax:717-242-8125
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2023-10-20
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Provider Licenses
StateLicense IDTaxonomies
PAMA053601363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant