Healthcare Provider Details

I. General information

NPI: 1255312112
Provider Name (Legal Business Name): CATHY A ARMSTRONG RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 A ST
PLUMMER ID
83851
US

IV. Provider business mailing address

PO 86
LATAH WA
99018-0084
US

V. Phone/Fax

Practice location:
  • Phone: 208-686-1767
  • Fax:
Mailing address:
  • Phone: 509-286-3034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN-27429
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: