Provider Demographics
NPI:1013995604
Name:CATHEY, MARY ANN (FNP)
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:CATHEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:477 N EL CAMINO REAL
Mailing Address - Street 2:SUITE A
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1328
Mailing Address - Country:US
Mailing Address - Phone:760-943-9111
Mailing Address - Fax:760-943-0180
Practice Address - Street 1:477 N EL CAMINO REAL
Practice Address - Street 2:SUITE A
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1328
Practice Address - Country:US
Practice Address - Phone:760-943-9111
Practice Address - Fax:760-943-0180
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP12008363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABI623ZMedicare PIN
CAP43250Medicare UPIN