Healthcare Provider Details

I. General information

NPI: 1083797898
Provider Name (Legal Business Name): CATHERINE CATES RABUN R. N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 U. S. HWY 1 N
LOUISVILLE GA
30434
US

IV. Provider business mailing address

297 MIDDLEGROUND RD
WAYNESBORO GA
30830-6402
US

V. Phone/Fax

Practice location:
  • Phone: 478-625-3716
  • Fax: 478-625-8201
Mailing address:
  • Phone: 478-625-3716
  • Fax: 478-625-8201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN123061
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: