Provider Demographics
NPI:1962801647
Name:HALKYARD, CATHARINE WINGATE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CATHARINE
Middle Name:WINGATE
Last Name:HALKYARD
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 1:740 S LIMESTONE SUITE A301
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0284
Mailing Address - Country:US
Mailing Address - Phone:859-323-6494
Mailing Address - Fax:859-257-4682
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-6839
Practice Address - Country:US
Practice Address - Phone:859-257-1000
Practice Address - Fax:859-257-8699
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA2506363AM0700X, 363AS0400X, 363A00000X
SC2153363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2067PAMedicaid
KYPA2506OtherKENTUCKY BOARD OF MEDICAL LICENSURE