Provider Demographics
NPI:1982462412
Name:CANTER, CATHERINE JOAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JOAN
Last Name:CANTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4035 S RIVERPOINT PKWY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85040-0723
Mailing Address - Country:US
Mailing Address - Phone:844-937-8679
Mailing Address - Fax:
Practice Address - Street 1:4035 S RIVERPOINT PKWY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-0723
Practice Address - Country:US
Practice Address - Phone:844-937-8679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN161118163WX0002X
AZ299384363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk