Provider Demographics
NPI:1912636242
Name:PEZZELLA, CATHERINE L (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:L
Last Name:PEZZELLA
Suffix:
Gender:F
Credentials:APRN, FNP-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:101 RIVERFRONT BLVD STE 700
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8823
Mailing Address - Country:US
Mailing Address - Phone:941-748-2417
Mailing Address - Fax:941-748-3694
Practice Address - Street 1:101 RIVERFRONT BLVD STE 700
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8823
Practice Address - Country:US
Practice Address - Phone:941-748-2417
Practice Address - Fax:941-748-3694
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020155363LF0000X
FL11020155363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily