Healthcare Provider Details

I. General information

NPI: 1013974575
Provider Name (Legal Business Name): KATHERINE M. TJADEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE M RHOADES

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 LINCOLN WAY
AMES IA
50014-3402
US

IV. Provider business mailing address

PO BOX 3014 1215 DUFF AVE MCFARLAND CLINIC PC
AMES IA
50010-3014
US

V. Phone/Fax

Practice location:
  • Phone: 515-956-4100
  • Fax: 515-956-4108
Mailing address:
  • Phone: 515-239-4501
  • Fax: 515-239-4446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001576
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: