Healthcare Provider Details

I. General information

NPI: 1790269496
Provider Name (Legal Business Name): CATHERINE HALLMARK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE BARR

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 GEARY ST SE
ALBANY OR
97322-6842
US

IV. Provider business mailing address

560 N CAMINO MERCADO STE 7
CASA GRANDE AZ
85122-5759
US

V. Phone/Fax

Practice location:
  • Phone: 541-812-5500
  • Fax:
Mailing address:
  • Phone: 520-836-5538
  • Fax: 520-876-0878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP11634
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number202006654NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: