Provider Demographics
NPI:1639317027
Name:LOETSCHER, CATHERINE KAY
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:KAY
Last Name:LOETSCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CATHERINE
Other - Middle Name:KAY
Other - Last Name:LOETSCHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1575 ROAD 136
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-9409
Mailing Address - Country:US
Mailing Address - Phone:307-778-4014
Mailing Address - Fax:
Practice Address - Street 1:1575 ROAD 136
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-9409
Practice Address - Country:US
Practice Address - Phone:307-778-4014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY112340800OtherPROVIDER NUMBER