Provider Demographics
NPI:1932601960
Name:SPRINGER, KATLYN RAE (PA-C)
Entity Type:Individual
Prefix:
First Name:KATLYN
Middle Name:RAE
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATLYN
Other - Middle Name:RAE
Other - Last Name:CAMPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7416 WHISTLESTOP DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-2825
Mailing Address - Country:US
Mailing Address - Phone:209-810-2532
Mailing Address - Fax:
Practice Address - Street 1:351 CYPRESS CREEK RD STE 204
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4657
Practice Address - Country:US
Practice Address - Phone:512-354-1283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA11834363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant