MEDICARE: MARY ANN CATHEY FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	NP12008	CA

General Provider Information

NPI Number	:	1013995604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ANN CATHEY FNP

Provider Business Mailing Address
First Line	:	477 N EL CAMINO REAL
Second Line	:	SUITE A
City	:	ENCINITAS
State	:	CA
Zip	:	92024-1328
Country	:	US
Telephone Number	:	760-943-9111
Fax Number	:	760-943-0180

Provider Business Practice Location Address
First Line	:	477 N EL CAMINO REAL
Second Line	:	SUITE A
City	:	ENCINITAS
State	:	CA
Zip	:	92024-1328
Country	:	US
Telephone Number	:	760-943-9111
Fax Number	:	760-943-0180

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	12/21/2015

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