Provider Demographics
NPI:1952952731
Name:TWISTOL, CATHLEEN ANN
Entity Type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:ANN
Last Name:TWISTOL
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 1:41544 270TH PLACE
Mailing Address - Street 2:
Mailing Address - City:AITKIN
Mailing Address - State:MN
Mailing Address - Zip Code:56431
Mailing Address - Country:US
Mailing Address - Phone:218-330-6885
Mailing Address - Fax:
Practice Address - Street 1:41544 270TH PLACE
Practice Address - Street 2:
Practice Address - City:AITKIN
Practice Address - State:MN
Practice Address - Zip Code:56431
Practice Address - Country:US
Practice Address - Phone:218-330-6885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider