Provider Demographics
NPI:1417041401
Name:GARNETT, CATHRYN LISA (FNP)
Entity type:Individual
Prefix:
First Name:CATHRYN
Middle Name:LISA
Last Name:GARNETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733946
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3946
Mailing Address - Country:US
Mailing Address - Phone:512-485-7200
Mailing Address - Fax:512-485-7224
Practice Address - Street 1:4100 DUVAL ROAD
Practice Address - Street 2:BLDG III SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759
Practice Address - Country:US
Practice Address - Phone:512-485-7200
Practice Address - Fax:512-485-7224
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX584009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173354501Medicaid
TX8B7042Medicare ID - Type Unspecified