Provider Demographics
NPI:1326195231
Name:FLOYD, KATHY R (PA-C)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:R
Last Name:FLOYD
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 1:104 SELMA DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3834
Mailing Address - Country:US
Mailing Address - Phone:540-678-2800
Mailing Address - Fax:540-678-2859
Practice Address - Street 1:104 SELMA DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3834
Practice Address - Country:US
Practice Address - Phone:540-678-2800
Practice Address - Fax:540-678-2859
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002457363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV4670A - C03895Medicare PIN