Provider Demographics
NPI:1679162036
Name:LACSAMANA, CATINA HOPE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CATINA
Middle Name:HOPE
Last Name:LACSAMANA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CATINA
Other - Middle Name:HOPE
Other - Last Name:BORDELON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4717 ASHLEY PLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32571-2513
Mailing Address - Country:US
Mailing Address - Phone:850-741-6868
Mailing Address - Fax:
Practice Address - Street 1:5113 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2035
Practice Address - Country:US
Practice Address - Phone:850-290-8410
Practice Address - Fax:866-574-6391
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily