Individual
KATLYN BIONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1001 WILLOW CREEK RD STE 1300, PRESCOTT, AZ 86301-1614
(928) 708-4545
(928) 458-2108
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
3638
AZ
363AS0400X
Surgical Physician Assistant
MA063485
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1182840
NCCPA
—
05
—
131415
—
AZ
Enumeration date
03/28/2022
Last updated
02/03/2025
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