Provider Demographics
NPI:1144425554
Name:GERETY, CATHERINE M (RN, ANP-C)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:GERETY
Suffix:
Gender:F
Credentials:RN, ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:1103 KINGS HWY N STE 203
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1983
Practice Address - Country:US
Practice Address - Phone:856-321-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN06801900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ039909XVAMedicare UPIN