Provider Demographics
NPI:1548951320
Name:CATO, BREANNA
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:CATO
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 1:345 STERLING POINTE LN APT 47
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-8032
Mailing Address - Country:US
Mailing Address - Phone:256-405-8294
Mailing Address - Fax:
Practice Address - Street 1:345 STERLING POINTE LN APT 47
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-8032
Practice Address - Country:US
Practice Address - Phone:256-405-8294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor