Provider Demographics
NPI:1689448490
Name:WESTRA, CATHRYN ROSE (FNP)
Entity Type:Individual
Prefix:
First Name:CATHRYN
Middle Name:ROSE
Last Name:WESTRA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 SAINT ALBANS LN STE B
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-6513
Mailing Address - Country:US
Mailing Address - Phone:305-318-7923
Mailing Address - Fax:
Practice Address - Street 1:16415 NORTHCROSS DR STE B
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-5001
Practice Address - Country:US
Practice Address - Phone:704-775-6029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC317588163WC0200X
NC5019147363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine