Provider Demographics
NPI:1922102615
Name:DENOBILE, CATHERINE ANN (NP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:DENOBILE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 29TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22213-1510
Mailing Address - Country:US
Mailing Address - Phone:703-533-1829
Mailing Address - Fax:
Practice Address - Street 1:50 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-359-0087
Practice Address - Fax:202-518-4675
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR112096363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00164687OtherRR MEDICARE
P31860Medicare UPIN
MD015500H76Medicare ID - Type Unspecified