Provider Demographics
NPI:1861627028
Name:CATLIN, THERESA LYNN (NP, RN)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:LYNN
Last Name:CATLIN
Suffix:
Gender:F
Credentials:NP, RN
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5 BOWEN CT
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-2493
Mailing Address - Country:US
Mailing Address - Phone:770-633-0433
Mailing Address - Fax:
Practice Address - Street 1:613 ROSELANE ST NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-6940
Practice Address - Country:US
Practice Address - Phone:770-792-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN172224163WX0200X, 363LA2200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WX0200XNursing Service ProvidersRegistered NurseOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA714989614CMedicaid
GA714989614CMedicaid
GA50BBHXFMedicare PIN