Provider Demographics
NPI:1447799952
Name:SOUDERS, CATHERINE R (RN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:R
Last Name:SOUDERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16090 HART RD
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44064-9785
Mailing Address - Country:US
Mailing Address - Phone:440-862-0111
Mailing Address - Fax:
Practice Address - Street 1:16090 HART RD
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:OH
Practice Address - Zip Code:44064-9785
Practice Address - Country:US
Practice Address - Phone:440-862-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH256342163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse