Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 8458 | NV |
NPI | 1285603159 |
---|---|
Provider Name | Dr. Cathy Jo Cantrell |
First Address | Reno, NV 89509-0907 |
Second Address | Reno, NV 89509-0907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 22/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0020199980 | (05) | NV |
E78323 | (02) |