Individual
KATHRYN AVINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 GRANT ST, GARY, IN 46402-6001
(219) 886-4000
Mailing address
600 GRANT ST, GARY, IN 46404
(219) 886-4710
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006950
IL
363A00000X
Physician Assistant
10001871A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578950424
—
IN
Enumeration date
04/17/2015
Last updated
06/22/2023
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