Individual
KATELYN MICHELLE KOFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10105 BANBURRY CROSS DRIVE, SUIRE 370, LAS VEGAS, NV 89144
(022) 604-5257
(702) 869-0133
Mailing address
10105 BANBURRY CROSS DRIVE, SUIRE 370, LAS VEGAS, NV 89144
(022) 604-5257
(702) 869-0133
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NV
Other
Enumeration date
01/31/2017
Last updated
07/15/2024
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