Healthcare Provider Details

I. General information

NPI: 1164520383
Provider Name (Legal Business Name): NINA MARIE CATLETT RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3166 COLLINS DR
MERCED CA
95348-3132
US

IV. Provider business mailing address

1691 THE ALAMEDA
SAN JOSE CA
95126-2203
US

V. Phone/Fax

Practice location:
  • Phone: 209-723-7751
  • Fax: 209-723-0295
Mailing address:
  • Phone: 408-287-7532
  • Fax: 408-287-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP7597
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberNP7597
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: