Provider Demographics
NPI:1417993320
Name:GROEGER, CATHERINE ANN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ANN
Last Name:GROEGER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-2741
Mailing Address - Country:US
Mailing Address - Phone:225-665-7877
Mailing Address - Fax:
Practice Address - Street 1:1651 HIGHWAY 51
Practice Address - Street 2:STE. #4
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-6376
Practice Address - Country:US
Practice Address - Phone:985-386-3405
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN036756 AP01798363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1561151Medicaid
LAS93862Medicare UPIN
LA5P2697910Medicare ID - Type Unspecified