MEDICARE: MS. CATHY L BERENS MSNAPRN

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	363L00000X	Nurse Practitioner	22143346	WY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	313909	OTHER	WY	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164533717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHY L BERENS MSNAPRN

Provider Business Mailing Address
First Line	:	940 E 3RD ST
Second Line	:	SUITE 107
City	:	CASPER
State	:	WY
Zip	:	82601-3237
Country	:	US
Telephone Number	:	307-265-1500
Fax Number	:	307-265-1506

Provider Business Practice Location Address
First Line	:	940 EAST 3RD STREET
Second Line	:	SUITE 107
City	:	CASPER
State	:	WY
Zip	:	82601-3200
Country	:	US
Telephone Number	:	307-265-1500
Fax Number	:	307-265-1506

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/17/2013

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