Healthcare Provider Details

I. General information

NPI: 1497775969
Provider Name (Legal Business Name): CATHERINE A. WORTH M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 S PACHECO ST STE 650
SANTA FE NM
87505-2300
US

IV. Provider business mailing address

2055 S PACHECO ST STE 650
SANTA FE NM
87505-2300
US

V. Phone/Fax

Practice location:
  • Phone: 505-772-9300
  • Fax:
Mailing address:
  • Phone: 505-772-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number017
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD017
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: