Individual
KATHERINE RENEE INGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
460 NORTHSIDE CHEROKEE BLVD STE 100, CANTON, GA 30115-8017
(770) 292-3490
(770) 721-5615
Mailing address
460 NORTHSIDE CHEROKEE BLVD STE 100, CANTON, GA 30115-8017
(770) 292-3490
(770) 721-5615
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
PA08835
TX
363A00000X
Physician Assistant
Primary
10173
GA
363A00000X
Physician Assistant
PA08835
TX
363A00000X
Physician Assistant
—
—
Other
Enumeration date
12/12/2013
Last updated
05/19/2021
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