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General NPI Number Information
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NPI Number | 1689602245
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Entity Type | Individual
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Provider Name | CATHY A. CUSTER C.R.N.P.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 205 S FRONT ST FL 4
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City | HARRISBURG
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State | PA
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Zip | 17104-1619
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Country | US
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Telephone | 717-231-8555
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Fax | 717-231-8568
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Provider Business Mailing Address
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Address Line | 1838 GREENE TREE RD SUITE 150- LL
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City | BALTIMORE
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State | MD
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Zip | 21208-6391
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Country | US
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Telephone | 410-602-9262
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Fax | 410-602-9276
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP017491
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | R096345
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License Number State | MD
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