Provider Demographics
NPI:1124016449
Name:MASCARI, CATHERINE BARBARA (CERTIFIED NURSE MW)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:BARBARA
Last Name:MASCARI
Suffix:
Gender:F
Credentials:CERTIFIED NURSE MW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1235 SAINT PAUL AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-2708
Mailing Address - Country:US
Mailing Address - Phone:651-698-8091
Mailing Address - Fax:651-644-2609
Practice Address - Street 1:1235 SAINT PAUL AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-2708
Practice Address - Country:US
Practice Address - Phone:651-698-8091
Practice Address - Fax:651-644-2609
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2023-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MNR1103100163W00000X
MN0172207VX0000X, 363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN514198200Medicaid
MN514198200Medicaid