Provider Demographics
NPI:1871037663
Name:FOGEL, KATRINA ANNE (PA-C)
Entity Type:Individual
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First Name:KATRINA
Middle Name:ANNE
Last Name:FOGEL
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:665 SIERRA ROSE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2060
Mailing Address - Country:US
Mailing Address - Phone:775-624-3382
Mailing Address - Fax:775-786-4901
Practice Address - Street 1:3595 US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:NV
Practice Address - Zip Code:89429-9613
Practice Address - Country:US
Practice Address - Phone:775-982-5000
Practice Address - Fax:775-982-3900
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2020-05-21
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Provider Licenses
StateLicense IDTaxonomies
NVPA1794363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant