Provider Demographics
NPI:1215212964
Name:GVOZDEN, CATHY (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:
Last Name:GVOZDEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 NAJOLES RD
Mailing Address - Street 2:STE E
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108
Mailing Address - Country:US
Mailing Address - Phone:410-729-0690
Mailing Address - Fax:410-729-4057
Practice Address - Street 1:251 NAJOLES RD
Practice Address - Street 2:STE E
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108
Practice Address - Country:US
Practice Address - Phone:410-729-0690
Practice Address - Fax:410-729-4057
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR069649363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics