Provider Demographics
NPI:1730558404
Name:LINDSEY, KATLIN RAE (PA-C)
Entity type:Individual
Prefix:
First Name:KATLIN
Middle Name:RAE
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATLIN
Other - Middle Name:RAE
Other - Last Name:PRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1 KENTON DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-1256
Mailing Address - Country:US
Mailing Address - Phone:304-306-8990
Mailing Address - Fax:877-471-5976
Practice Address - Street 1:1 KENTON DR STE 100
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-1256
Practice Address - Country:US
Practice Address - Phone:304-306-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-23
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1930363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant