Provider Demographics
NPI:1932987732
Name:QUEHL, KATELYN LASHELL (PA-C)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:LASHELL
Last Name:QUEHL
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:3374 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:NY
Mailing Address - Zip Code:13142-2614
Mailing Address - Country:US
Mailing Address - Phone:315-530-7479
Mailing Address - Fax:
Practice Address - Street 1:105 COUNTY ROUTE 45A STE 100
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-6665
Practice Address - Country:US
Practice Address - Phone:315-342-6771
Practice Address - Fax:315-342-2842
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical