Healthcare Provider Details

I. General information

NPI: 1578093027
Provider Name (Legal Business Name): KATHRYN ANN BEYER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN JANIKAS PA

II. Dates (important events)

Enumeration Date: 06/18/2017
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 DAGGETT DR
WEST SPRINGFIELD MA
01089-4638
US

IV. Provider business mailing address

280 CHESTNUT ST FL 2
SPRINGFIELD MA
01199-1001
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-9110
  • Fax: 413-794-1080
Mailing address:
  • Phone: 413-794-3909
  • Fax: 413-794-1619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: