Provider Demographics
NPI:1487337515
Name:MILANAK, KATELYN MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARIE
Last Name:MILANAK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1606 LEONA AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-9731
Mailing Address - Country:US
Mailing Address - Phone:412-651-5399
Mailing Address - Fax:
Practice Address - Street 1:4515 COORS BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-3699
Practice Address - Country:US
Practice Address - Phone:505-596-2200
Practice Address - Fax:505-596-2280
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-10-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program