Provider Demographics
NPI:1194389353
Name:SERAFEN, KATHERINE (PA-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:SERAFEN
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 1:7209 CREEDMOOR RD STE 105
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-1695
Mailing Address - Country:US
Mailing Address - Phone:919-307-9461
Mailing Address - Fax:919-714-0909
Practice Address - Street 1:7209 CREEDMOOR RD STE 105
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1695
Practice Address - Country:US
Practice Address - Phone:919-307-9461
Practice Address - Fax:919-714-0909
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-23
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9798363A00000X
NC0010-13643363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant