Provider Demographics
NPI:1285488015
Name:ANDERSON, CATRINA
Entity type:Individual
Prefix:
First Name:CATRINA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10802 INSPIRATION DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46259-7697
Mailing Address - Country:US
Mailing Address - Phone:317-454-2209
Mailing Address - Fax:
Practice Address - Street 1:5214 S EAST ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-2098
Practice Address - Country:US
Practice Address - Phone:463-221-2613
Practice Address - Fax:463-221-2612
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide