Provider Demographics
NPI:1972263622
Name:PHAM, KATE (PA-C)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:PHAM
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:9950 W FLAMINGO RD STE 105
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8555
Mailing Address - Country:US
Mailing Address - Phone:702-998-9001
Mailing Address - Fax:
Practice Address - Street 1:9950 W FLAMINGO RD STE 105
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8555
Practice Address - Country:US
Practice Address - Phone:702-998-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-22
Last Update Date:2022-05-03
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant