Provider Demographics
NPI:1871151779
Name:KIRK, CATHERINE GRAINGER (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:GRAINGER
Last Name:KIRK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 ROBINHOOD MEDICAL PLZ
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5472
Practice Address - Country:US
Practice Address - Phone:336-718-0800
Practice Address - Fax:336-718-0871
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-09120363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant