Provider Demographics
NPI:1932331626
Name:PRINZING, CATHERINE A (CNS)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:PRINZING
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 E GOLDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1026
Mailing Address - Country:US
Mailing Address - Phone:208-367-5170
Mailing Address - Fax:208-367-5180
Practice Address - Street 1:1000 N CURTIS ROAD
Practice Address - Street 2:SUITE 305
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-1347
Practice Address - Country:US
Practice Address - Phone:208-367-6130
Practice Address - Fax:208-367-7316
Is Sole Proprietor?:No
Enumeration Date:2009-08-14
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCNS32A364S00000X
IDCNS-32A364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1250802Medicare Oscar/Certification