Individual
KATIE ANN LISABETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5140 LIBERTY AVE STE 102, PITTSBURGH, PA 15224-2215
(412) 681-2300
Mailing address
5140 LIBERTY AVE STE 102, PITTSBURGH, PA 15224-2215
(412) 681-2300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA061808
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13974792
CAQH
—
Enumeration date
02/21/2017
Last updated
01/19/2021
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