Provider Demographics
NPI:1114278918
Name:VISSER, CATELLA (RN)
Entity Type:Individual
Prefix:MS
First Name:CATELLA
Middle Name:
Last Name:VISSER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 BRANDYWINE BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2953
Mailing Address - Country:US
Mailing Address - Phone:267-975-2453
Mailing Address - Fax:
Practice Address - Street 1:261 CHAPMAN RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5423
Practice Address - Country:US
Practice Address - Phone:302-266-3246
Practice Address - Fax:302-266-7991
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0041573163W00000X
PARN36258163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse