Provider Demographics
NPI:1538635263
Name:ONEAL, KATHI (PA-C)
Entity Type:Individual
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First Name:KATHI
Middle Name:
Last Name:ONEAL
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:4003 KRESGE WAY
Mailing Address - Street 2:STE 300
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4652
Mailing Address - Country:US
Mailing Address - Phone:502-897-5139
Mailing Address - Fax:502-896-6218
Practice Address - Street 1:2818 GRANT LINE RD STE 2
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2492
Practice Address - Country:US
Practice Address - Phone:812-914-7038
Practice Address - Fax:812-924-7661
Is Sole Proprietor?:No
Enumeration Date:2018-10-20
Last Update Date:2019-02-06
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Provider Licenses
StateLicense IDTaxonomies
IN10002571A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant