Individual
MRS. KATHERINE ELISE MCDOUGAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
107 SUNNYBROOK RD, RALEIGH, NC 27610-1827
(984) 974-4832
Mailing address
107 SUNNYBROOK RD, RALEIGH, NC 27610-1827
(984) 974-4832
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
0010-05730
NC
363AM0700X
Medical Physician Assistant
Primary
0010-05730
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154708402
—
NC
Enumeration date
05/06/2015
Last updated
02/10/2026
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