Provider Demographics
NPI:1417491424
Name:CATHEY, JEREMY (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:CATHEY
Suffix:
Gender:M
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 HIGHWAY 99 N
Mailing Address - Street 2:STE 2
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-9152
Mailing Address - Country:US
Mailing Address - Phone:541-708-0256
Mailing Address - Fax:
Practice Address - Street 1:165 BEECH SPRINGS RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:LA
Practice Address - Zip Code:71251-2013
Practice Address - Country:US
Practice Address - Phone:318-259-4435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-09
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201702886NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily