Healthcare Provider Details

I. General information

NPI: 1356349849
Provider Name (Legal Business Name): KATHERINE PATTERSON NEELY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE LOUISE PATTERSON NEELY MD

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4044 ROUTE 130
IRWIN PA
15642-7808
US

IV. Provider business mailing address

4044 ROUTE 130
IRWIN PA
15642-7808
US

V. Phone/Fax

Practice location:
  • Phone: 724-527-6651
  • Fax: 724-527-0957
Mailing address:
  • Phone: 724-527-6651
  • Fax: 724-527-0957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD050545L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: