Provider Demographics
NPI:1568298222
Name:GOLDEN, KILEY CATHERINE (PA-C)
Entity type:Individual
Prefix:MISS
First Name:KILEY
Middle Name:CATHERINE
Last Name:GOLDEN
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 1:2023 GRESHAM LN
Mailing Address - Street 2:
Mailing Address - City:DAVIDSONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21035-2410
Mailing Address - Country:US
Mailing Address - Phone:815-494-1404
Mailing Address - Fax:
Practice Address - Street 1:2021 K ST NW STE 300
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1012
Practice Address - Country:US
Practice Address - Phone:301-942-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1218025363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant