Provider Demographics
NPI:1821585449
Name:JENNINGS, CATHERINE WINN (PT)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:WINN
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 LONGS RD
Mailing Address - Street 2:
Mailing Address - City:LURAY
Mailing Address - State:VA
Mailing Address - Zip Code:22835-4915
Mailing Address - Country:US
Mailing Address - Phone:540-742-1635
Mailing Address - Fax:
Practice Address - Street 1:555 1ST ST
Practice Address - Street 2:
Practice Address - City:LURAY
Practice Address - State:VA
Practice Address - Zip Code:22835-2008
Practice Address - Country:US
Practice Address - Phone:540-742-1635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305002280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist