Provider Demographics
NPI:1861547168
Name:PURDY, KATHERINE JANE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:JANE
Last Name:PURDY
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2841 TEMPLAR KNIGHT DR
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-2755
Mailing Address - Country:US
Mailing Address - Phone:770-938-7903
Mailing Address - Fax:770-279-1000
Practice Address - Street 1:354 ARCADO RD NW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2815
Practice Address - Country:US
Practice Address - Phone:770-925-4200
Practice Address - Fax:770-279-1000
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA002896363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical