Provider Demographics
NPI:1124064373
Name:MICHAELS, CATHERINE M (PA-C)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:M
Other - Last Name:TRACKIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4093
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:27 CJEMS LN
Practice Address - Street 2:
Practice Address - City:MIFFLINTOWN
Practice Address - State:PA
Practice Address - Zip Code:17059-8384
Practice Address - Country:US
Practice Address - Phone:717-436-5578
Practice Address - Fax:717-436-5911
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA-000071-L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS34865Medicare UPIN
PA058075Medicare ID - Type Unspecified