Provider Demographics
NPI:1043250541
Name:WAYAND, CATHY EVELYN (NP)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:EVELYN
Last Name:WAYAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85733-3100
Mailing Address - Country:US
Mailing Address - Phone:520-722-3777
Mailing Address - Fax:520-296-6224
Practice Address - Street 1:6890 E SUNRISE DRIVE STE 120 #223
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750
Practice Address - Country:US
Practice Address - Phone:520-624-4342
Practice Address - Fax:520-624-4337
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN183790163W00000X
AZAP5303363L00000X
NC900201363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPENDINGMedicaid
NCS93915Medicare UPIN
AZPENDINGMedicare PIN
NC2599087Medicare ID - Type Unspecified