Provider Demographics
NPI:1245812924
Name:COTRUPE, CATHERINE CARMELLA (PA-C)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:CARMELLA
Last Name:COTRUPE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 WILLIAM D FITCH PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-7447
Mailing Address - Country:US
Mailing Address - Phone:979-704-6879
Mailing Address - Fax:
Practice Address - Street 1:750 WILLIAM D FITCH PKWY STE 320
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-7447
Practice Address - Country:US
Practice Address - Phone:979-704-6879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant