Provider Demographics
NPI:1881684785
Name:MCCURDY, CATHY (PAC)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:MCCURDY
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BLANCA AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-2340
Mailing Address - Country:US
Mailing Address - Phone:719-589-2511
Mailing Address - Fax:719-587-1372
Practice Address - Street 1:103 CHICO CT
Practice Address - Street 2:
Practice Address - City:MONTE VISTA
Practice Address - State:CO
Practice Address - Zip Code:81144-1065
Practice Address - Country:US
Practice Address - Phone:719-852-9400
Practice Address - Fax:719-852-9311
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO87363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO76823229Medicaid
COCOAAA3885Medicare PIN
P59948Medicare UPIN