Doctor Name: | MS. J CATHARINE HERRICK |
NPI Number: | 1619013489 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPNP |
License Number: | R30013 |
Business Practice Address: | 280 1st St Holloman Afb, NM - 883308273 |
Business Phone Number: | 5055572365 |
Business Fax Number: | 5055721965 |
Mailing Address: | Po Box 813, HOLLOMAN AFB |
State: | NM |
Postal Code: | 883300813 |
Phone Number: | 5055723658 |
Fax Number: | 5055721965 |
NPI Enumeration Date: | 01/29/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | R30013 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |