Provider Demographics
NPI:1912860396
Name:DESROSIER, CATHERINE LEE (PA-C)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LEE
Last Name:DESROSIER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3370 S MERCY ROAD
Mailing Address - Street 2:SUITE 314
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-0417
Mailing Address - Country:US
Mailing Address - Phone:480-782-0993
Mailing Address - Fax:
Practice Address - Street 1:3370 S MERCY ROAD
Practice Address - Street 2:SUITE 314
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-0417
Practice Address - Country:US
Practice Address - Phone:480-782-0993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11422363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant