Provider Demographics
NPI:1265479182
Name:SHOWFETY, CATHERINE P
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:P
Last Name:SHOWFETY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 W MARKET ST
Mailing Address - Street 2:STE 100
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-4443
Mailing Address - Country:US
Mailing Address - Phone:336-632-3505
Mailing Address - Fax:336-665-6188
Practice Address - Street 1:3511 W MARKET ST
Practice Address - Street 2:STE 100
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-4443
Practice Address - Country:US
Practice Address - Phone:336-632-3505
Practice Address - Fax:336-665-6188
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC68904364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2596963Medicare ID - Type Unspecified