Provider Demographics
NPI:1134850829
Name:HENDERSHOT, CATHERINE JOANN (APRN-CNP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JOANN
Last Name:HENDERSHOT
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 GARFIELD AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-5444
Mailing Address - Country:US
Mailing Address - Phone:304-424-2276
Mailing Address - Fax:
Practice Address - Street 1:705 GARFIELD AVE STE 220
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-5444
Practice Address - Country:US
Practice Address - Phone:304-424-2276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV113625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily