Van Atta, Katherine Grace

Van Atta, Katherine Grace is an individual health care provider with primary practice located at 5000 E Shennum Dr , Wasilla AK 99654-7718. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Van Atta, Katherine Grace can be contacted via phone (907) 373-3420.

Contact Information

Primary practice address
5000 E Shennum Dr Wasilla AK 99654-7718
Phone: (907) 373-3420
Fax: (907) 376-7847
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 879 Alaska
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X

Profile Details

NPI number 1740358167
LBN Legal business name Van Atta, Katherine Grace
Credentials PA-C, CNM
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2006
Last updated Feb 19th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740358167 NPPES
Alaska MEDICAID MDA0205

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