Provider Demographics
NPI:1043221906
Name:TAGHER, CATHERINE GANNON (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:GANNON
Last Name:TAGHER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7309 US HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-5561
Mailing Address - Country:US
Mailing Address - Phone:859-525-8181
Mailing Address - Fax:859-525-8289
Practice Address - Street 1:7309 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-5561
Practice Address - Country:US
Practice Address - Phone:859-525-8181
Practice Address - Fax:859-525-8289
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4601P363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65932758Medicaid