Healthcare Provider Details

I. General information

NPI: 1023393410
Provider Name (Legal Business Name): CATHY SHOWFETY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2011
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 1/2 STATE ST
GREENSBORO NC
27405-5657
US

IV. Provider business mailing address

1903 DICKENS DR
GREENSBORO NC
27410-2217
US

V. Phone/Fax

Practice location:
  • Phone: 336-324-3739
  • Fax: 336-632-3503
Mailing address:
  • Phone: 336-324-3739
  • Fax: 336-632-3503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number68904
License Number StateNC

VIII. Authorized Official

Name: MRS. CATHY P SHOWFETY
Title or Position: PSYCHOLOGIST/MENTAL HEALTH
Credential: APRN,MSN,CSN
Phone: 336-324-3739