Provider Demographics
NPI:1194420968
Name:MILLIGAN, KATHRYN ANNE (PA-C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANNE
Last Name:MILLIGAN
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 1:3725 STRATAVON DR NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-8663
Mailing Address - Country:US
Mailing Address - Phone:330-232-6730
Mailing Address - Fax:
Practice Address - Street 1:3725 STRATAVON DR NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-8663
Practice Address - Country:US
Practice Address - Phone:330-232-6730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008096RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant