Basic Information
| Provider Information | |||||||||
| NPI: | 1083692834 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THURBER | ||||||||
| FirstName: | KATIE | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | MS, PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 197 ADAMS RD | ||||||||
| Address2: | |||||||||
| City: | WILLIAMSTOWN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 012672930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4134588182 | ||||||||
| FaxNumber: | 4134583140 | ||||||||
| Practice Location | |||||||||
| Address1: | 71 HOSPITAL AVE | ||||||||
| Address2: | |||||||||
| City: | NORTH ADAMS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4136645710 | ||||||||
| FaxNumber: | 4136645773 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2006 | ||||||||
| LastUpdateDate: | 05/14/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 1601 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.