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NPI Code Detail

MEDICARE: KATHERINE CANTRELL WHCNP

MEDICARE: KATHERINE CANTRELL WHCNP
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
1363LX0001XObstetrics & Gynecology Nurse Practitioner529851TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1529851OTHERTXLICENSE

General Provider Information

NPI Number : 1164505798
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE CANTRELL WHCNP
Provider Business Mailing Address
First Line : PO BOX 1655
Second Line : 308 W. ROCK ISLAND
City : BOYD
State : TX
Zip : 76023-1655
Country : US
Telephone Number : 940-433-5122
Fax Number : 940-433-8309
Provider Business Practice Location Address
First Line : 1001 W EAGLE DR
Second Line :
City : DECATUR
State : TX
Zip : 76234-3745
Country : US
Telephone Number : 940-627-7829
Fax Number : 940-627-7464
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 04/23/2008

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Directions to “ KATHERINE CANTRELL WHCNP” Practice Location

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