MEDICARE: KATELYN MCKIBBEN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP034588	PA

General Provider Information

NPI Number	:	1770453789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN MCKIBBEN

Provider Business Mailing Address
First Line	:	100 SHENANGO AVE
Second Line	:
City	:	SHARON
State	:	PA
Zip	:	16146-1503
Country	:	US
Telephone Number	:	724-253-3428
Fax Number	:	724-253-3029

Provider Business Practice Location Address
First Line	:	3339 PERRY HIGHWAY
Second Line	:
City	:	SHEAKLEYVILLE
State	:	PA
Zip	:	16151
Country	:	US
Telephone Number	:	724-253-3428
Fax Number	:	724-253-3029

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

Provider Enumeration Date	:	11/06/2025
Last Update Date	:	04/17/2026

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Directions to “ KATELYN MCKIBBEN ” Practice Location

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