Provider Demographics
NPI:1184083719
Name:MOFFA, CATHERINE M (CRNP)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:M
Last Name:MOFFA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:M
Other - Last Name:LEEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:409 S 2ND ST
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 S FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-2010
Practice Address - Country:US
Practice Address - Phone:717-782-3380
Practice Address - Fax:717-782-5716
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015964363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103154166Medicaid