MEDICARE: CATHERINE JOAN CANTER 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	163WX0002X	High-Risk Obstetric Registered Nurse	RN161118	AZ
2	363LF0000X	Family Nurse Practitioner	299384	AZ

General Provider Information

NPI Number	:	1982462412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE JOAN CANTER FNP-C

Provider Business Mailing Address
First Line	:	4035 S RIVERPOINT PKWY
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-0723
Country	:	US
Telephone Number	:	844-937-8679
Fax Number	:

Provider Business Practice Location Address
First Line	:	4035 S RIVERPOINT PKWY
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-0723
Country	:	US
Telephone Number	:	844-937-8679
Fax Number	:

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

Provider Enumeration Date	:	03/11/2024
Last Update Date	:	03/11/2024

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