Provider Demographics
NPI:1518219476
Name:CANAVA, CATHRYN JAYNE (RN)
Entity Type:Individual
Prefix:
First Name:CATHRYN
Middle Name:JAYNE
Last Name:CANAVA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CATHRYN
Other - Middle Name:JAYNE
Other - Last Name:ORONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 9261
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-9261
Mailing Address - Country:US
Mailing Address - Phone:940-764-7230
Mailing Address - Fax:940-764-7255
Practice Address - Street 1:1301 3RD ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-2245
Practice Address - Country:US
Practice Address - Phone:940-764-8725
Practice Address - Fax:940-764-8179
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA626137163W00000X
TX1109936363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse