Provider Demographics
NPI:1073587341
Name:MOUZIN, CATHERINE S (FNP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:S
Last Name:MOUZIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-1340
Mailing Address - Country:US
Mailing Address - Phone:812-885-0520
Mailing Address - Fax:812-885-0517
Practice Address - Street 1:406 N 1ST ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1340
Practice Address - Country:US
Practice Address - Phone:812-885-0520
Practice Address - Fax:812-885-0517
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000815363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200520110Medicaid
INP00670410OtherRAILROAD MEDICARE
IN000000598594OtherANTHEM
IN200520110Medicaid
INP00670410OtherRAILROAD MEDICARE