Provider Demographics
NPI:1265681837
Name:MEAD, CATHERINE MARIE (FNP/PA)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:MARIE
Last Name:MEAD
Suffix:
Gender:F
Credentials:FNP/PA
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:MARIE
Other - Last Name:MEAD-HUTCHINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP/PA
Mailing Address - Street 1:1405 W BADDOUR PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-2567
Mailing Address - Country:US
Mailing Address - Phone:615-449-5771
Mailing Address - Fax:615-449-5740
Practice Address - Street 1:1405 W BADDOUR PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-2567
Practice Address - Country:US
Practice Address - Phone:615-449-5771
Practice Address - Fax:615-449-5740
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2013-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13506363A00000X
TN2184363A00000X
CA7450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily