Provider Demographics
NPI:1043491095
Name:WHITE, CATHERINE A (ANP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:A
Last Name:WHITE
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 HIGHWAY 133
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-1933
Mailing Address - Country:US
Mailing Address - Phone:970-963-3350
Mailing Address - Fax:970-963-2958
Practice Address - Street 1:1340 HIGHWAY 133
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-1933
Practice Address - Country:US
Practice Address - Phone:970-963-3350
Practice Address - Fax:970-963-2958
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO107523363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner