Provider Demographics
NPI:1124178553
Name:BECKER-PRATHER, CATHERINE A (NPC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:BECKER-PRATHER
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1029
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30703-1029
Mailing Address - Country:US
Mailing Address - Phone:706-624-1001
Mailing Address - Fax:706-602-2784
Practice Address - Street 1:111 LAUREL CREEK RD SE # A
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-7000
Practice Address - Country:US
Practice Address - Phone:706-624-1001
Practice Address - Fax:706-602-2784
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN092978NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA50BBKBQMedicare ID - Type Unspecified
GAP98764Medicare UPIN
GAGRP7191Medicare PIN