Provider Demographics
NPI:1649689613
Name:CATHELL, KELSEY QUINN (MS, MSPAS, ATC, PA-C)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:QUINN
Last Name:CATHELL
Suffix:
Gender:F
Credentials:MS, MSPAS, ATC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W BERKELEY ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-5514
Mailing Address - Country:US
Mailing Address - Phone:724-437-5600
Mailing Address - Fax:
Practice Address - Street 1:500 W BERKELEY ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-5596
Practice Address - Country:US
Practice Address - Phone:724-437-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA060572363A00000X
WV2255A2300X
PA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA060572OtherPHYSICIAN ASSISTANT LICENSE
WV2246OtherWV BOARD OF MEDICINE