Provider Demographics
NPI:1710598792
Name:GREADY, CATHARINE ANNE
Entity Type:Individual
Prefix:
First Name:CATHARINE
Middle Name:ANNE
Last Name:GREADY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 E 8TH ST APT 4313
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-7436
Mailing Address - Country:US
Mailing Address - Phone:719-963-1135
Mailing Address - Fax:
Practice Address - Street 1:3014 E 8TH ST APT 4313
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-7436
Practice Address - Country:US
Practice Address - Phone:719-963-1135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer