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General NPI Number Information
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NPI Number | 1407282890
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Entity Type | Individual
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Provider Name | KATHRYN ANN GORMANDY PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/18/2013
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 4850 GRANDE DR
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City | PENSACOLA
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State | FL
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Zip | 32504
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Country | US
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Telephone | 850-477-4447
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Fax | 850-477-2225
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Provider Business Mailing Address
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Address Line | 4850 GRANDE DR
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City | PENSACOLA
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State | FL
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Zip | 32504-5940
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Country | US
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Telephone | 251-518-9756
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Fax | 850-477-2225
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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 | PA9107395
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License Number State | FL
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