Provider Demographics
NPI:1528259025
Name:HUNTER, KATHRYN ANN (PA-C)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:ANN
Last Name:HUNTER
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 1:1905 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-2638
Mailing Address - Country:US
Mailing Address - Phone:541-882-4961
Mailing Address - Fax:541-883-5211
Practice Address - Street 1:1905 MAIN ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-2638
Practice Address - Country:US
Practice Address - Phone:541-882-4961
Practice Address - Fax:541-883-5211
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA01159363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P24897OtherUPIN