Provider Demographics
NPI:1598233900
Name:BAINES, CATHERINE DENISE
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:DENISE
Last Name:BAINES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5237 KIMBARK WOODS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134
Mailing Address - Country:US
Mailing Address - Phone:901-218-7082
Mailing Address - Fax:901-507-6600
Practice Address - Street 1:697 WHITEHAVE LANE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38109
Practice Address - Country:US
Practice Address - Phone:901-218-7082
Practice Address - Fax:901-507-6600
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant