Provider Demographics
NPI:1063807006
Name:STANKOVICH, CATHERINE (NP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:STANKOVICH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 DIPINO DR
Mailing Address - Street 2:
Mailing Address - City:COLLIERS
Mailing Address - State:WV
Mailing Address - Zip Code:26035-1206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4000 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2364
Practice Address - Country:US
Practice Address - Phone:740-264-8039
Practice Address - Fax:740-264-8049
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.17066363LF0000X
OHAPRN.CNP.022149363LF0000X
WVAPRN87239-NP-C363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0124203Medicaid
WV3810029122Medicaid
OH0124203Medicaid
WV3810029122Medicaid