MEDICARE: MISS KATY SHURILLA PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	50.002857RX	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538304381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KATY SHURILLA PA-C

Provider Business Mailing Address
First Line	:	100 DEBARTOLO PL STE 200
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-6095
Country	:	US
Telephone Number	:	330-729-8146
Fax Number	:	330-965-5229

Provider Business Practice Location Address
First Line	:	3694 STARRS CENTRE DR
Second Line	:
City	:	CANFIELD
State	:	OH
Zip	:	44406-9514
Country	:	US
Telephone Number	:	330-702-1310
Fax Number	:	330-702-1344

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2008
Last Update Date	:	01/12/2026

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