Provider Demographics
NPI:1841594546
Name:FORLENZA, CATHERINE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:FORLENZA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 N RIVER ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18705-1033
Mailing Address - Country:US
Mailing Address - Phone:570-552-7150
Mailing Address - Fax:570-552-7155
Practice Address - Street 1:672 N RIVER ST
Practice Address - Street 2:SUITE 111
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18705-1033
Practice Address - Country:US
Practice Address - Phone:570-552-7150
Practice Address - Fax:570-552-7155
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP001371G363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1029424310001Medicaid
PA1029424310002Medicaid
PA1029424310001Medicaid