Provider Demographics
NPI:1053036962
Name:ROSS, KATHARINE WINDRIVER (PA-C)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:WINDRIVER
Last Name:ROSS
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:13634 N 93RD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4915
Mailing Address - Country:US
Mailing Address - Phone:623-815-2484
Mailing Address - Fax:623-815-2483
Practice Address - Street 1:13634 N 93RD AVE STE 300
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4915
Practice Address - Country:US
Practice Address - Phone:623-815-2484
Practice Address - Fax:623-815-2483
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-12-29
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant