Provider Demographics
NPI:1609392745
Name:ANNA, CATHERINE MICHELLE (NP)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:MICHELLE
Last Name:ANNA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2901 BLUE RIDGE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6423
Mailing Address - Country:US
Mailing Address - Phone:197-846-8189
Mailing Address - Fax:919-784-6828
Practice Address - Street 1:2901 BLUE RIDGE RD STE 203
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6423
Practice Address - Country:US
Practice Address - Phone:197-846-8189
Practice Address - Fax:919-784-6828
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009814363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health