Provider Demographics
NPI:1366507626
Name:CARRABRE, CATHERINE GAYLE (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:GAYLE
Last Name:CARRABRE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:GAYLE
Other - Last Name:EINARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6465 WAYZATA BLVD
Mailing Address - Street 2:SUITE 900
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1728
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:952-512-5650
Practice Address - Street 1:501 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-1715
Practice Address - Country:US
Practice Address - Phone:952-442-2163
Practice Address - Fax:952-442-5903
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5307225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HP59174OtherHEALTHPARTNERS
6406102OtherMEDICA
86G22CAOtherBLUE CROSS BLUE SHIELD
969991030949OtherPREFERREDONE