Provider Demographics
NPI:1093147787
Name:CATHY BERENS, PC
Entity Type:Organization
Organization Name:CATHY BERENS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERENS
Authorized Official - Suffix:
Authorized Official - Credentials:MSNAPRN
Authorized Official - Phone:307-265-1500
Mailing Address - Street 1:940 EAST 3RD STREET
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-3200
Mailing Address - Country:US
Mailing Address - Phone:307-265-1500
Mailing Address - Fax:307-265-1506
Practice Address - Street 1:940 EAST 3RD STREET
Practice Address - Street 2:SUITE 107
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-3200
Practice Address - Country:US
Practice Address - Phone:307-265-1500
Practice Address - Fax:307-265-1506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY22143346363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty