Provider Demographics
NPI:1356984322
Name:MASON, KATELYN MARIE (PA)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARIE
Last Name:MASON
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:506 E CHEVES ST STE 202
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2616
Mailing Address - Country:US
Mailing Address - Phone:843-646-8040
Mailing Address - Fax:843-646-8049
Practice Address - Street 1:3980 HIGHWAY 9 E STE 300
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-8165
Practice Address - Country:US
Practice Address - Phone:843-646-8040
Practice Address - Fax:843-646-8049
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2024-07-22
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Provider Licenses
StateLicense IDTaxonomies
SC3382363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant