Provider Demographics
NPI:1447030127
Name:PLANKENHORN, KATHRYN ANN (PA-C)
Entity type:Individual
Prefix:MISS
First Name:KATHRYN
Middle Name:ANN
Last Name:PLANKENHORN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:418 CEDARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-7514
Mailing Address - Country:US
Mailing Address - Phone:570-220-3694
Mailing Address - Fax:
Practice Address - Street 1:175 PINE ST STE 200
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-6549
Practice Address - Country:US
Practice Address - Phone:570-326-2447
Practice Address - Fax:570-326-1247
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA064992363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical