Individual
KATHRYN LYN SCULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7287 W RIDGE RD, FAIRVIEW, PA 16415
(814) 877-2360
(814) 877-3561
Mailing address
7287 W RIDGE RD, FAIRVIEW, PA 16415-1130
(814) 877-2360
(814) 877-7715
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA006347
PA
363AM0700X
Medical Physician Assistant
MA061933
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1098405700001
—
PA
Enumeration date
10/15/2020
Last updated
07/25/2024
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