Provider Demographics
NPI:1912512161
Name:CATES, CAROLINE M
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:M
Last Name:CATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38035 W 345TH ST S
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:OK
Mailing Address - Zip Code:74010-4982
Mailing Address - Country:US
Mailing Address - Phone:918-367-2870
Mailing Address - Fax:
Practice Address - Street 1:38035 W 345TH ST S
Practice Address - Street 2:
Practice Address - City:BRISTOW
Practice Address - State:OK
Practice Address - Zip Code:74010-4982
Practice Address - Country:US
Practice Address - Phone:918-367-2870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care