Provider Demographics
NPI:1477545861
Name:HARRISON, CATHY ANN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:ANN
Last Name:HARRISON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 FOX HURST DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-3742
Mailing Address - Country:US
Mailing Address - Phone:804-379-9369
Mailing Address - Fax:804-379-6626
Practice Address - Street 1:3401 FOX HURST DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-3742
Practice Address - Country:US
Practice Address - Phone:804-379-9369
Practice Address - Fax:804-379-6626
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001067523367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered