Provider Demographics
NPI:1083638829
Name:SPAGNOLA, CATHERINE RODGERS (APRN,CS)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:RODGERS
Last Name:SPAGNOLA
Suffix:
Gender:F
Credentials:APRN,CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CENTERBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06409-1071
Mailing Address - Country:US
Mailing Address - Phone:860-767-3105
Mailing Address - Fax:860-767-3218
Practice Address - Street 1:40 MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTERBROOK
Practice Address - State:CT
Practice Address - Zip Code:06409-1071
Practice Address - Country:US
Practice Address - Phone:860-767-3105
Practice Address - Fax:860-767-3218
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001198363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health