Healthcare Provider Details

I. General information

NPI: 1124703251
Provider Name (Legal Business Name): LAQUWANDA CATCHINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2023
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 E MOUNTAIN VIEW RD STE 220
SCOTTSDALE AZ
85258-5172
US

IV. Provider business mailing address

9201 E MOUNTAIN VIEW RD STE 220
SCOTTSDALE AZ
85258-5172
US

V. Phone/Fax

Practice location:
  • Phone: 877-564-3627
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number902602
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number902602
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number902602
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number902602
License Number StateMS
# 5
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number902602
License Number StateMS
# 6
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number902602
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: