Provider Demographics
NPI:1588280382
Name:WHITE, KATHERINE (PA-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:509 PLANTATION ST APT 113
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-4339
Mailing Address - Country:US
Mailing Address - Phone:601-310-5655
Mailing Address - Fax:
Practice Address - Street 1:207 SOUTHBRIDGE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2548
Practice Address - Country:US
Practice Address - Phone:508-832-7118
Practice Address - Fax:508-832-7166
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant