Kathleen Shea Allen

Individual provider Active NPI Physician Assistant · Fort Stewart, GA

NPI 1043786619 · NPPES record last updated Aug 26, 2025

Key facts

NPI
1043786619
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
Practice address
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone
(912) 435-6965
NPI assigned
Oct 22, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Yes

Addresses

Primary practice location

1061 Harmon Ave
Fort Stewart, GA 31314-5641

Mailing address

1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (571) 801-7375

Other providers in Fort Stewart, GA

All providers in Fort Stewart, GA · Physician Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.