Provider Demographics
NPI:1609107788
Name:SOWERS, CATHY G (CNP)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:G
Last Name:SOWERS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:G
Other - Last Name:PENNING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNP
Mailing Address - Street 1:353 FAIRMONT BLVD
Mailing Address - Street 2:ATTEN MEDICAL STAFF SERVICES
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-6000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1420 N 10TH ST
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783
Practice Address - Country:US
Practice Address - Phone:605-642-8414
Practice Address - Fax:605-642-8618
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000586363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDCP000586OtherLICENSE NUMBER