Provider Demographics
NPI:1407932114
Name:STOWE, CATHERINE J (CPNP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:J
Last Name:STOWE
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 HEATHERSTONE CT
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-5396
Mailing Address - Country:US
Mailing Address - Phone:815-609-9597
Mailing Address - Fax:
Practice Address - Street 1:500 WILCOX ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6169
Practice Address - Country:US
Practice Address - Phone:815-740-3490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209002873363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics