Provider Demographics
NPI:1821748872
Name:CLINGERMAN, KATARINA W (PA-C)
Entity Type:Individual
Prefix:
First Name:KATARINA
Middle Name:W
Last Name:CLINGERMAN
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 1:220 CAMPUS BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2889
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:
Practice Address - Street 1:120 CAMPUS DR STE 211
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-7561
Practice Address - Country:US
Practice Address - Phone:681-247-1260
Practice Address - Fax:681-247-1260
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2958363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1180898OtherNCCPA
WV2610OtherWV BOARD OF MEDICINE