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General NPI Number Information
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NPI Number | 1306474713
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Entity Type | Individual
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Provider Name | KATE MCKINNON PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 02/15/2026
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Provider Practice Location Address
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Address Line | 801 MACARTHUR BLVD STE 305
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City | MUNSTER
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State | IN
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Zip | 46321-2920
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Country | US
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Telephone | 219-703-2401
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Fax | 219-703-6687
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Provider Business Mailing Address
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Address Line | 1400 S MICHIGAN AVE APT 702
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City | CHICAGO
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State | IL
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Zip | 60605-3716
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Country | US
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Telephone | 224-305-4143
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10004481A
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License Number State | IN
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