Provider Demographics
NPI:1699556779
Name:SIMMERS, KATELIN MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:KATELIN
Middle Name:MARIE
Last Name:SIMMERS
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 1:3925 BUTLER ST UNIT A317
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-3280
Mailing Address - Country:US
Mailing Address - Phone:540-820-0759
Mailing Address - Fax:
Practice Address - Street 1:5200 CENTRE AVE STE 715
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1327
Practice Address - Country:US
Practice Address - Phone:412-748-5772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA064876208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)