Provider Demographics
NPI:1942857859
Name:WAVERKA, KATHRYN CARLING (PA-C)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:CARLING
Last Name:WAVERKA
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 1:1603 E HIGH ST STE A
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5061
Mailing Address - Country:US
Mailing Address - Phone:610-970-4700
Mailing Address - Fax:610-970-5635
Practice Address - Street 1:1603 E HIGH ST STE A
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5061
Practice Address - Country:US
Practice Address - Phone:610-970-4700
Practice Address - Fax:610-970-5635
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA060909363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical