Provider Demographics
NPI:1316336936
Name:FEEZERJONES, CATHY
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:FEEZERJONES
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 1:1242 FRONTIER DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:WY
Mailing Address - Zip Code:82633-2722
Mailing Address - Country:US
Mailing Address - Phone:307-358-5193
Mailing Address - Fax:
Practice Address - Street 1:1242 FRONTIER DR
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:WY
Practice Address - Zip Code:82633-2722
Practice Address - Country:US
Practice Address - Phone:307-358-5193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator