Individual
KATRINA RENAE STOTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110004999
VA
363AM0700X
Medical Physician Assistant
Primary
0110-004999
VA
Other
Enumeration date
07/15/2015
Last updated
08/13/2026
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