Healthcare Provider Details

I. General information

NPI: 1134632391
Provider Name (Legal Business Name): CATHERINE HUNTER GARVEY CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2017
Last Update Date: 11/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 AVENUE PL APT 2502
ATLANTA GA
30329-4146
US

IV. Provider business mailing address

1540 AVENUE PL APT 2502
ATLANTA GA
30329-4146
US

V. Phone/Fax

Practice location:
  • Phone: 423-902-6653
  • Fax:
Mailing address:
  • Phone: 423-902-6653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN272064
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number217421
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN272064
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: