Individual
KATELYN SQUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
965 W CHANDLER HEIGHTS RD, CHANDLER, AZ 85248-5724
(480) 460-4949
(480) 460-5858
Mailing address
6285 S HIGLEY RD, GILBERT, AZ 85298-4262
(480) 460-4949
(480) 460-5858
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
946941
—
AZ
Enumeration date
08/06/2014
Last updated
07/17/2020
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