Individual
KATHRYN PROVONCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4755 OGLETOWN STANTON RD STE 5A43, NEWARK, DE 19718-2200
(302) 623-0188
Mailing address
200 HYGEIA DR STE 2300, NEWARK, DE 19713-2049
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/16/2016
Last updated
02/28/2019
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