| Doctor Name: | KATHERINE L WALSH |
| NPI Number: | 1003015280 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C/MPH |
| License Number: | PA9104989 |
| Business Practice Address: | 425 N Lee St Suite 202 Jacksonville, FL - 322041127 |
| Business Phone Number: | 9043663738 |
| Business Fax Number: | 9043543571 |
| Mailing Address: | 1893 Kingsley Ave, Suite C ORANGE PARK |
| State: | FL |
| Postal Code: | 320734491 |
| Phone Number: | 9042762044 |
| Fax Number: | 9042762106 |
| NPI Enumeration Date: | 07/17/2007 |
| NPI Last Update Date: | 01/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA9104989 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |