NPI 1447640123

Katelyn Maben, PAC

Practitioner Physician Assistant Aurora, MO

Practice location

Address: 550 S Hudson Ave, Aurora, MO 65605-2362
Phone: (417) 678-5176
Mailing address: 1401 S Fremont Ave, Springfield, MO 65804-1105

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 2015002491 (MO)

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Registry record

NPI: 1447640123
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Feb 2015
Record last updated: 10 May 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.