Provider Demographics
NPI:1902998222
Name:CATT, DONNA JEAN (PA-C)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:CATT
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 1:50 ANDOVER COURT
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25443-1635
Mailing Address - Country:US
Mailing Address - Phone:315-243-3792
Mailing Address - Fax:
Practice Address - Street 1:10715 DOWNSVILLE PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740
Practice Address - Country:US
Practice Address - Phone:240-313-9910
Practice Address - Fax:240-313-9915
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011060-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC0004515Medicaid
WV2630OtherUPDATE STATE LICENSE NUMBERS