Provider Demographics
NPI:1073810404
Name:GICHEMA, CATHY (ANP-BC)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:GICHEMA
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 HARRY HINES BLVD
Mailing Address - Street 2:CHEST MEDICINE CLINIC, 4TH FLOOR
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:221 W COLORADO BLVD STE 525
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2312
Practice Address - Country:US
Practice Address - Phone:214-956-4525
Practice Address - Fax:214-960-5681
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX790561363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDQ5280OtherMEDICARE RR PALMETTO
TX280980801Medicaid
TXD07564OtherMEDICARE RR PALMETTO
TXTXB121675Medicare PIN