Healthcare Provider Details

I. General information

NPI: 1326100470
Provider Name (Legal Business Name): MRS. CATHERINE LYNN FORZATO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER
LANDSTUHL GERMANY
09012
DE

IV. Provider business mailing address

PSC 2 BOX 9525
APO AE
09012
DE

V. Phone/Fax

Practice location:
  • Phone: 011496371868160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR143256
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: