Provider Demographics
NPI:1689924417
Name:CATHEY, KAREN (FIS II, DIS II)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:CATHEY
Suffix:
Gender:F
Credentials:FIS II, DIS II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 LOPEZ S.W.
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105
Mailing Address - Country:US
Mailing Address - Phone:505-877-7060
Mailing Address - Fax:505-877-7063
Practice Address - Street 1:1101 LOPEZ S.W.
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105
Practice Address - Country:US
Practice Address - Phone:505-877-7060
Practice Address - Fax:505-877-7063
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM0000000000Medicaid