Provider Demographics
NPI:1245820687
Name:ENTWISTLE, CATHERINE LYNNE (RN,BSN)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:LYNNE
Last Name:ENTWISTLE
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 PALMER ST
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:NY
Mailing Address - Zip Code:13340-1428
Mailing Address - Country:US
Mailing Address - Phone:315-894-7168
Mailing Address - Fax:315-895-4032
Practice Address - Street 1:605 PALMER ST
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:NY
Practice Address - Zip Code:13340-1428
Practice Address - Country:US
Practice Address - Phone:315-894-7168
Practice Address - Fax:315-895-4032
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY635237-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool