Provider Demographics
NPI:1780817494
Name:VOSBURY, KATHRYN REID (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:REID
Last Name:VOSBURY
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 1:120 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1097
Mailing Address - Country:US
Mailing Address - Phone:301-520-5375
Mailing Address - Fax:
Practice Address - Street 1:120 ASPEN DR
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-1097
Practice Address - Country:US
Practice Address - Phone:301-520-5375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC5-0000689OtherDELAWARE BOARD OF MEDICAL PRACTICE