MEDICARE: KATRINA ANNE FOGEL PA.-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA1794	NV

General Provider Information

NPI Number	:	1871037663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA ANNE FOGEL PA.-C

Provider Business Mailing Address
First Line	:	665 SIERRA ROSE DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-2060
Country	:	US
Telephone Number	:	775-624-3382
Fax Number	:	775-786-4901

Provider Business Practice Location Address
First Line	:	3595 US HIGHWAY 50
Second Line	:
City	:	SILVER SPRINGS
State	:	NV
Zip	:	89429-9613
Country	:	US
Telephone Number	:	775-982-5000
Fax Number	:	775-982-3900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2016
Last Update Date	:	05/21/2020

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