Provider Demographics
NPI:1003068149
Name:ROZIER, CATHERINE A
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:ROZIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:A
Other - Last Name:OTTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M P T
Mailing Address - Street 1:1506 W SAINT JOSEPH ST
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775-1504
Mailing Address - Country:US
Mailing Address - Phone:573-517-7900
Mailing Address - Fax:573-517-7969
Practice Address - Street 1:1506 W SAINT JOSEPH ST
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63775-1504
Practice Address - Country:US
Practice Address - Phone:573-517-7900
Practice Address - Fax:573-517-7969
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007036587174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO220664766Medicare PIN