Provider Demographics
NPI:1619171220
Name:SIEVER, KATHERINE CAROLINE (PA - C)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:CAROLINE
Last Name:SIEVER
Suffix:
Gender:F
Credentials:PA - C
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:CAROLINE
Other - Last Name:SCHROEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1970 ROANOKE BLVD
Mailing Address - Street 2:SALEM VAMC 11AC GROUP 2
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-6404
Mailing Address - Country:US
Mailing Address - Phone:540-982-2463
Mailing Address - Fax:540-224-1958
Practice Address - Street 1:1970 ROANOKE BLVD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-6404
Practice Address - Country:US
Practice Address - Phone:540-982-2463
Practice Address - Fax:540-224-1958
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1076801363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant