Provider Demographics
NPI:1760493100
Name:SILTA, KATHERINE A (PA-C)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:SILTA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC DEPTARTMENT OF ORTHOPAEDICS
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-7590
Mailing Address - Fax:603-650-2097
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC DEPTARTMENT OF ORTHOPAEDICS
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-7590
Practice Address - Fax:603-650-2097
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0550030216363AS0400X
NH0163363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
18P955OtherMVP
NH30005595Medicaid
VT9000319Medicaid
NH107529Y0NH01OtherBLUECROSS-ANTHEM
VT19446OtherBLUECROSS
228224OtherCIGNA
S25622Medicare UPIN
VT9000319Medicaid
NHAP0861Medicare PIN