MEDICARE: MRS. CATHERINE JEAN MCDONALD 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	4704129945	MI

General Provider Information

NPI Number	:	1992767297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHERINE JEAN MCDONALD FNP

Provider Business Mailing Address
First Line	:	608 YORKSHIRE CT
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23322-5804
Country	:	US
Telephone Number	:	757-392-1630
Fax Number	:

Provider Business Practice Location Address
First Line	:	1618 POCAHONTAS DRIVE
Second Line	:	MEDICAL READINESS DIVISION, COMNAVSURFLANT
City	:	NORFOLK
State	:	VA
Zip	:	23508
Country	:	US
Telephone Number	:	757-445-9108
Fax Number	:

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

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	10/08/2015

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