Provider Demographics
NPI:1164682449
Name:STRAND, CATHY JO MARIE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:CATHY JO
Middle Name:MARIE
Last Name:STRAND
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:CATHY JO
Other - Middle Name:MARIE
Other - Last Name:STRAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:209 TRANQUILITY TRL
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-2345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:209 TRANQUILITY TRL
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-2345
Practice Address - Country:US
Practice Address - Phone:715-222-8389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7740363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
38315900OtherMEDICAID INDEPENDENT NURSE PROVIDER NUMBER