Provider Demographics
NPI:1972257715
Name:GOLEY, KATHERINE NICOLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:NICOLE
Last Name:GOLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:4589 KAPP DR
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-5920
Mailing Address - Country:US
Mailing Address - Phone:937-673-7679
Mailing Address - Fax:
Practice Address - Street 1:2350 MIAMI VALLEY DR STE 400
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4780
Practice Address - Country:US
Practice Address - Phone:937-228-1731
Practice Address - Fax:937-228-7827
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-03-15
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant