Provider Demographics
NPI:1790575009
Name:CHADWICK, KATHARINE ALLISON (PA-C)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ALLISON
Last Name:CHADWICK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-9000
Mailing Address - Fax:
Practice Address - Street 1:1285 NININGER RD
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-1086
Practice Address - Country:US
Practice Address - Phone:651-480-4200
Practice Address - Fax:651-480-4306
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN15392363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant