National Provider Identifier Database

NICOLETTE MCDERMOTT KETCHUM, PAC – NPI #1417947813
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.


Contact Information

NICOLETTE MCDERMOTT KETCHUM, PAC
HWY 160 & MP 394.3
KAYENTA, AZ86033
Phone: 928-697-4000
Fax:
Website:
Specialty Taxonomy Code
* Physician Assistant 363A00000X

* Indicates primary specialty

NPI Profile & details for NICOLETTE MCDERMOTT KETCHUM

NPI Number 1417947813
Credentials PAC
Entity Individual
Enumeration date 10/26/2005
Last updated 01/03/2019 - About 7 years ago
Sole proprietor1 No
Identifiers
  • NM License #: PA20030034
  • AZ Medicaid: 803727
  • CO Medicaid: 61276031
  • NM Medicaid: 40907503
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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