MEDICARE: TERRA CATHERS FNP-C

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	AP5192	AZ

General Provider Information

NPI Number	:	1841628260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRA CATHERS FNP-C

Provider Business Mailing Address
First Line	:	2022 E GARY CIR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85213-4608
Country	:	US
Telephone Number	:	309-279-4162
Fax Number	:

Provider Business Practice Location Address
First Line	:	2030 W BASELINE RD # 182-2273
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-6574
Country	:	US
Telephone Number	:	309-279-4162
Fax Number	:	800-991-2996

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

Provider Enumeration Date	:	10/22/2013
Last Update Date	:	08/13/2022

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