Provider Demographics
NPI:1902436678
Name:FARNSWORTH, KATHERINE ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:FARNSWORTH
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 1:1343 BOSTON POST RD APT 101
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-3481
Mailing Address - Country:US
Mailing Address - Phone:860-669-6156
Mailing Address - Fax:860-664-0285
Practice Address - Street 1:1343 BOSTON POST RD APT 101
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-3481
Practice Address - Country:US
Practice Address - Phone:860-669-6156
Practice Address - Fax:860-664-0285
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4743363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant