Provider Demographics
NPI:1245841840
Name:VACHULA, KATLYN (PA-C)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:VACHULA
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 1:1132 HUNTINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01098-9563
Mailing Address - Country:US
Mailing Address - Phone:413-657-3200
Mailing Address - Fax:
Practice Address - Street 1:725 NORTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4109
Practice Address - Country:US
Practice Address - Phone:413-447-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant