Provider Demographics
NPI:1750052031
Name:PELTZ, KATHERINE MARIE MCDANIELS (PA-C)
Entity Type:Individual
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First Name:KATHERINE
Middle Name:MARIE MCDANIELS
Last Name:PELTZ
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:37 CATBIRD LN
Mailing Address - Street 2:
Mailing Address - City:NORTH OAKS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-6465
Mailing Address - Country:US
Mailing Address - Phone:651-895-6995
Mailing Address - Fax:
Practice Address - Street 1:200 UNIVERSITY AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2507
Practice Address - Country:US
Practice Address - Phone:651-291-2848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-25
Last Update Date:2021-09-25
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant