Provider Demographics
NPI:1972653509
Name:BROWN, CATHLEEN JOY CAGLE (CNM)
Entity Type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:JOY CAGLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:5307 N MILLBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7315
Mailing Address - Country:US
Mailing Address - Phone:559-760-1826
Mailing Address - Fax:
Practice Address - Street 1:1122 S ST
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1430
Practice Address - Country:US
Practice Address - Phone:559-495-3120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1434367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife