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Individual
KATHERINE M. TJADEN
Active
Individual
KATHERINE M. TJADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001576
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0152082
MEDICAID HOSPITAL
IA
05
—
0638536
—
IA
01
—
I12876
MEDICARE B
IA
Enumeration date
04/28/2006
Last updated
02/22/2024
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