MS. KATHLEEN A MCDONALD PA NPI 1487763603

NPI Information

NPI: 1487763603
Provider Name: MS. KATHLEEN A MCDONALD, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
1009 SPRUCE ST
ESPANOLA, NM
ZIP 87532
Phone: (505) 747-4144
Get Directions

MS. Kathleen A Mcdonald, PA is a surgical physician assistant in Espanola, NM. MS. Kathleen A Mcdonald, PA NPI is 1487763603. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1009 SPRUCE ST
ESPANOLA, NM
ZIP 87532-740
Phone: (505) 747-4144
Fax: (505) 747-3213

The enumeration date for this NPI number is 8/30/2006 and was last updated on 4/2/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA2003-0045	NEW MEXICO	No
2	363AS0400X	Physician Assistant	Surgical	PA2003-0045	NEW MEXICO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	342405500	MEDICARE ID-TYPE UNSPECIFIED	NEW MEXICO
2	Q04058	MEDICARE UPIN	NEW MEXICO
3	67289258	MEDICAID	NEW MEXICO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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