Provider Demographics
NPI:1801287479
Name:FURR, KATIE (PA-C)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:FURR
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 1:1908 HILCO ST STE B
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-6388
Mailing Address - Country:US
Mailing Address - Phone:704-983-3855
Mailing Address - Fax:704-985-1031
Practice Address - Street 1:1908 HILCO ST
Practice Address - Street 2:SUITE B
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-6387
Practice Address - Country:US
Practice Address - Phone:704-983-3855
Practice Address - Fax:704-985-1031
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-05485363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant