Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Katherine Marie Lally, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1649239187

Katherine Marie Lally, PHYSICIANASSISTANT is a Physician Assistant in Saint Louis, Missouri. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

12639 Old Tesson Rd Ste 115
Saint Louis, MO 63128-2786
Phone: (314) 849-0311
Fax: (314) 849-4423
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1649239187
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedMarch 22, 2006
Last updated in NPPESAugust 19, 2025
Certification dateAugust 19, 2025

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