Provider Demographics
NPI:1174504310
Name:HOSTETTLER, CATHY J (ARNP)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:J
Last Name:HOSTETTLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:J
Other - Last Name:LEHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-467-6789
Mailing Address - Fax:319-467-7400
Practice Address - Street 1:3640 MIDDLEBURY RD
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-2712
Practice Address - Country:US
Practice Address - Phone:319-467-6789
Practice Address - Fax:319-467-7400
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008030245163W00000X, 363LF0000X
OHRN205728163W00000X
KS14-123468-122163WG0000X
IAA156990363LF0000X, 363L00000X
KS75985363LF0000X
OHNP05614363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH363LF0000XOtherFAMILY NURSE PRACTITIONER
OH34402722OtherCERTIFICATE NUMBER
OH363LF0000XOtherFAMILY NURSE PRACTITIONER