Provider Demographics
NPI:1336995364
Name:O'CONNELL, KATHRYN ANNETTE (PA-C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANNETTE
Last Name:O'CONNELL
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Gender:
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7925 VININGS OAK LN APT 528
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5118
Mailing Address - Country:US
Mailing Address - Phone:704-773-1904
Mailing Address - Fax:
Practice Address - Street 1:7925 VININGS OAK LN APT 528
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5118
Practice Address - Country:US
Practice Address - Phone:704-773-1904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2025-02-19
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant