Provider Demographics
NPI:1548799877
Name:CARNAHAN, CATHERINE D (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:D
Last Name:CARNAHAN
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154-8265
Mailing Address - Country:US
Mailing Address - Phone:937-444-0952
Mailing Address - Fax:937-444-0953
Practice Address - Street 1:621 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154-8265
Practice Address - Country:US
Practice Address - Phone:937-444-0952
Practice Address - Fax:937-444-0953
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH402731163W00000X
OHAPRN.CNP.021114363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse