Provider Demographics
NPI:1407731748
Name:CROSSLEY, KATLYNN (PA-C)
Entity type:Individual
Prefix:
First Name:KATLYNN
Middle Name:
Last Name:CROSSLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5967 TIPPERARY MNR
Mailing Address - Street 2:
Mailing Address - City:CLARENCE CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:14032-9509
Mailing Address - Country:US
Mailing Address - Phone:716-628-2800
Mailing Address - Fax:
Practice Address - Street 1:5967 TIPPERARY MNR
Practice Address - Street 2:
Practice Address - City:CLARENCE CENTER
Practice Address - State:NY
Practice Address - Zip Code:14032-9509
Practice Address - Country:US
Practice Address - Phone:716-628-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant