Provider Demographics
NPI:1205480522
Name:ROSS, CATHERINE (CNP, PMHNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:ROSS
Suffix:
Gender:
Credentials:CNP, PMHNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 E LAKE ST FL 5
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-4385
Mailing Address - Country:US
Mailing Address - Phone:612-596-9438
Mailing Address - Fax:612-329-4500
Practice Address - Street 1:2215 E LAKE ST FL 5
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-4385
Practice Address - Country:US
Practice Address - Phone:612-596-9438
Practice Address - Fax:612-329-4500
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6717363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily