Provider Demographics
NPI:1619213535
Name:POKORNY, CATHERINE SCOTT (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:SCOTT
Last Name:POKORNY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:SCOTT
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:445 CENTENNIAL AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2870
Mailing Address - Country:US
Mailing Address - Phone:406-723-4075
Mailing Address - Fax:
Practice Address - Street 1:445 CENTENNIAL AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2870
Practice Address - Country:US
Practice Address - Phone:406-723-4075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT19555363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant