Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 209005068 | IL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | CNP-02940 | NM |
NPI | 1003026279 |
---|---|
Provider Name | Kathleen Cathey |
First Address | Las Cruces, NM 88005-3423 |
Second Address | Las Cruces, NM 88005-2818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 28/12/2020 |