Provider Demographics
NPI:1396722377
Name:LAPE, KATHRYN J (PAC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:J
Last Name:LAPE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 E CUNNINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-5903
Mailing Address - Country:US
Mailing Address - Phone:724-283-0212
Mailing Address - Fax:724-283-2404
Practice Address - Street 1:131 E CUNNINGHAM ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5903
Practice Address - Country:US
Practice Address - Phone:724-283-0212
Practice Address - Fax:724-283-2404
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001696L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1542933Medicaid
PA1542933Medicaid
PA066725K8RMedicare PIN