Individual provider · Type 1 NPI

Caitlen M. Petschke, PA-C

Medical Physician Assistant · Johnson City, TN

NPI number 1558669986 Active

Practice location

101 Med Tech Pkwy, Ste. 405
Johnson City, TN 37604-4007

Fax (423) 929-2531

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700XPA200351 (LA)
Medical Physician Assistant Primary 363AM0700X2275 (TN)

Medical Physician Assistant: Definition to come...

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About NPI 1558669986

Caitlen M. Petschke, PA-C's National Provider Identifier is 1558669986, issued on Mar 9, 2011. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Johnson City, TN. The record was last updated on Aug 15, 2013.