MEDICARE: MRS. CATHY J CLODFELTER RN, MSN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	71001304A	IN

General Provider Information

NPI Number	:	1437137163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHY J CLODFELTER RN, MSN, FNP-C

Provider Business Mailing Address
First Line	:	1542 S BLOOMINGTON ST
Second Line	:	SUITE 1300
City	:	GREENCASTLE
State	:	IN
Zip	:	46135-2212
Country	:	US
Telephone Number	:	765-653-2700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1542 S BLOOMINGTON ST
Second Line	:	SUITE 1300
City	:	GREENCASTLE
State	:	IN
Zip	:	46135-2212
Country	:	US
Telephone Number	:	765-653-2700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	03/31/2021

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