Healthcare Provider Details

I. General information

NPI: 1265574354
Provider Name (Legal Business Name): JUDY H. CATRETT A.P.R.N-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 01/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 E 6TH AVE
BUENA VISTA GA
31803-9714
US

IV. Provider business mailing address

131 E 6TH AVE PO BOX 177
BUENA VISTA GA
31803-9714
US

V. Phone/Fax

Practice location:
  • Phone: 229-649-2273
  • Fax: 229-649-2270
Mailing address:
  • Phone: 229-649-2273
  • Fax: 229-649-2270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN041402
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: