Provider Demographics
NPI:1346737707
Name:ACHTERT, KATIE (CNM)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:
Last Name:ACHTERT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MISS
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:ISAACS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1098 W BALTIMORE PIKE STE 3109
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5139
Mailing Address - Country:US
Mailing Address - Phone:484-443-2880
Mailing Address - Fax:
Practice Address - Street 1:1098 W BALTIMORE PIKE STE 3109
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5139
Practice Address - Country:US
Practice Address - Phone:484-443-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-20
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW010490367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty