KATELYN HANNABACH (NPI# 1083180723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083180723 |
| Entity Type | Individual |
| Full Name | KATELYN HANNABACH |
| Credential | PA |
| Practice Address |
21323 S Ellsworth Loop Rd Ste 101 Queen Creek AZ 85142 |
| Mailing Address |
21323 S Ellsworth Loop Rd Ste 101 Queen Creek AZ 85142-9865 |
| Practice Telephone | 4803078440 |
| Enumeration Date | 2018-10-20 |
| Last Update Date | 2019-10-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 7594 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 21323 S Ellsworth Loop Rd Ste 101, Queen Creek, AZ 85142 | 4803078440 |
| Street Address |
21323 S ELLSWORTH LOOP RD STE 101 |
| City | QUEEN CREEK |
| State | AZ |
| Zip Code | 85142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033683982 | Rittenhouse Medical Group, LLC | Physical Therapist | 21323 S Ellsworth Loop Rd Ste 101, Queen Creek, AZ 85142-9865 | 2019-01-14 |
| 1548734403 | Qc District Medical Group LLC | Physical Medicine & Rehabilitation | 21323 S Ellsworth Loop Rd Ste 101, Queen Creek, AZ 85142-9865 | 2019-01-14 |
| 1467928804 | Ellsworth Medical Group LLC | Chiropractor | 21323 S Ellsworth Loop Rd Ste 101, Queen Creek, AZ 85142-9865 | 2018-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093346033 | Arizona Dental Professionals, P.C. | Dentist | 20311 S Ellsworth Rd Ste 101, Queen Creek, AZ 85142 | 2020-01-29 |
| 1073158903 | Jonathan Corey Barber | Physical Therapy Assistant | 22424 South Ellsworth Loop Road, #464, Queen Creek, AZ 85142 | 2019-11-14 |
| 1689142333 | Erin Sohr | Occupational Therapy Assistant | 4594 W Federal Way, San Tan Valley, AZ 85142 | 2018-11-10 |
| 1043701899 | Brittany Leigh Amor | Dentist | 18550 E Rittenhouse Rd Ste 103, Queen Creek, AZ 85142 | 2018-05-28 |
| 1861925604 | Shani Thompson | Student in an Organized Health Care Education/Training Program | 22437 S 209th Way, Queen Creek, AZ 85142 | 2017-04-08 |
| 1689115164 | 360 Physical Therapy LLC | Physical Therapist | 21576 S Ellsworth Loop Rd, 150, Queen Creek, AZ 85142 | 2017-03-16 |
| 1891233714 | Candee J. Eisenhart | Nurse Practitioner | 21321 E Ocotillo Rd Ste 102, Queen Creek, AZ 85142 | 2017-02-11 |
| 1790231546 | Carrie Church | Nurse Practitioner | 20185 E Ocotillo Rd Ste 104, Queen Creek, AZ 85142 | 2016-08-31 |
| 1669836649 | Horizon Health and Wellness, Inc. | Community/Behavioral Health | 22713 S. Ellsworth Road, Building A, Queen Creek, AZ 85142 | 2016-04-06 |
| 1104285485 | Kellie M Kotwicki | Behavioral Analyst | 18521 E Queen Creek Rd., Suite 105-627, Queen Creek, AZ 85142 | 2016-02-16 |
| Find all providers in zip 85142 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | 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, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134452337 | Kari Lynn Giarrizzo | Physician Assistant | 20715 E Ocotillo Rd Ste 102, Queen Creek, AZ 85142-6118 | 2009-09-08 |
| 1932353638 | Kristi Marie Preston | Physician Assistant | 24298 S 199th St, Queen Creek, AZ 85142-3336 | 2008-11-06 |
| 1962970343 | Haley Laene Bohl Mejias | Physician Assistant | 20715 E Ocotillo Rd Ste 102, Queen Creek, AZ 85142-6118 | 2018-11-05 |
| 1114446630 | Kyle Alexander Hunsaker | Physician Assistant | 21321 E Ocotillo Rd Ste 133, Queen Creek, AZ 85142-5995 | 2017-09-15 |
| 1144776113 | Timothy Palmer Lane | Physician Assistant | 21321 E Ocotillo Rd, Queen Creek, AZ 85142-5996 | 2016-08-30 |
| 1790891463 | Joseph M. Harrison | Physician Assistant | 20713 E Ocotillo Rd, Ste 100, Queen Creek, AZ 85242-6117 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407456585 | Chelsea Lee Townsend | Physician Assistant | 6823 S 9th Ave, Phoenix, AZ 85041-6752 | 2020-10-28 |
| 1780283580 | Daryl Howden | Physician Assistant | 800 E Curry Rd Apt 3019, Tempe, AZ 85281-7057 | 2020-10-22 |
| 1669079109 | Elizabeth Yushuva Rpac, Pllc | Physician Assistant | 23220 N 71st Dr, Glendale, AZ 85310-5872 | 2020-10-07 |
| 1972100949 | Amanda Alcantar | Physician Assistant | 8822 W Minnezona Ave, Phoenix, AZ 85037-1499 | 2020-10-02 |
| 1700483898 | Athena Marie Arbuckle | Physician Assistant | 3815 E Bell Rd Ste 3600, Phoenix, AZ 85032-2166 | 2020-10-02 |
| 1033725437 | Kayla Gutierrez | Physician Assistant | 4820 W Mcrae Way, Glendale, AZ 85308-4821 | 2020-09-21 |
| 1356957062 | Kylee Ann Lattomus | Physician Assistant | 26008 N 47th Dr, Phoenix, AZ 85083-1681 | 2020-09-17 |
| 1275148280 | Patricia Miriam Rus | Physician Assistant | 23615 N 105th Dr, Peoria, AZ 85383-1195 | 2020-09-15 |
| 1457966640 | Stephanie Alonso | Physician Assistant | 7725 N Sun Flair Dr, Tucson, AZ 85741-1582 | 2020-09-14 |
| 1043825367 | Lauren Elizabeth Fraijo | Physician Assistant | 13575 W Indian School Rd Ste 700, Litchfield Park, AZ 85340-4905 | 2020-09-14 |
| Find all providers with the same taxonomy | ||||
| City | QUEEN CREEK |
| Zip Code | 85142 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.