Individual provider · Type 1 NPI

Katherine Marie Lally, PHYSICIAN ASSISTANT

Physician Assistant · St. Louis, MO

NPI number 1649239187 Active

Practice location

12639 Old Tesson Rd Ste 115
St. Louis, MO 63128-2786

Call (314) 849-0311 Map

Fax (314) 849-4423

Mailing address

845 N New Ballas Ct Fl 2
St. Louis, MO 63141-7134

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1649239187

Katherine Marie Lally, PHYSICIAN ASSISTANT's National Provider Identifier is 1649239187, issued on Mar 22, 2006. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in St. Louis, MO. The record was last updated on Aug 19, 2025.