Provider Demographics
NPI:1750369633
Name:HAMILTON, KATHERINE SENSEL (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:SENSEL
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:LYNN
Other - Last Name:SENSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4130 DUTCHMANS LN
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4713
Mailing Address - Country:US
Mailing Address - Phone:502-897-1794
Mailing Address - Fax:502-897-0093
Practice Address - Street 1:4130 DUTCHMANS LN
Practice Address - Street 2:SUITE 300
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4713
Practice Address - Country:US
Practice Address - Phone:502-897-1794
Practice Address - Fax:502-897-0093
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10001815A363A00000X
363AM0700X
KYPA1022363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100006870Medicaid
IN300008421Medicaid
000000508868OtherANTHEM
KY1277618Medicare PIN
ININ1920011Medicare PIN
000000508868OtherANTHEM