Individual
KATHERINE SMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1618 S MILLENIUM WAY STE 100, MERIDIAN, ID 83642-6457
(208) 884-3376
(208) 884-0858
Mailing address
169 ASHLEY AVENUE, 2ND FLOOR MAIN HOPSITAL H268, CHARLESTON, SC 29425-8905
(843) 792-7097
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3253
SC
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/03/2018
Last updated
03/16/2026
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