Provider Demographics
NPI:1932401288
Name:MCCARTHY, KATHARINE E (PA)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:E
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4024 PRITCHARD PL
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-6962
Mailing Address - Country:US
Mailing Address - Phone:585-735-1296
Mailing Address - Fax:
Practice Address - Street 1:6211 S HIGHLAND DR # 4124
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84121-2125
Practice Address - Country:US
Practice Address - Phone:585-734-1296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-18
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14247063-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY18007A/J400037314OtherMCR PTAN