Provider Demographics
NPI:1013498435
Name:CLINGAN, CATHERINE ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:CLINGAN
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 1:139 ASHBROOKE BLVD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7775
Mailing Address - Country:US
Mailing Address - Phone:601-540-2927
Mailing Address - Fax:
Practice Address - Street 1:1006 TREETOPS BLVD STE 104
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7645
Practice Address - Country:US
Practice Address - Phone:601-939-1808
Practice Address - Fax:601-939-1808
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902778363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner