Provider Demographics
NPI:1073540217
Name:GUTOWSKI, CATHERINE A (CRNP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:GUTOWSKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2395 GARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-5209
Mailing Address - Country:US
Mailing Address - Phone:724-347-1861
Mailing Address - Fax:724-347-2532
Practice Address - Street 1:2395 GARDEN WAY
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-5209
Practice Address - Country:US
Practice Address - Phone:724-347-1861
Practice Address - Fax:724-347-2532
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP003648C363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2359620Medicaid
S48177Medicare UPIN
OH2359620Medicaid