Provider Demographics
NPI:1982464103
Name:SURRENCY, CATRINA
Entity type:Individual
Prefix:
First Name:CATRINA
Middle Name:
Last Name:SURRENCY
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 1:101 OAK BEND DR
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6722
Mailing Address - Country:US
Mailing Address - Phone:267-516-7506
Mailing Address - Fax:
Practice Address - Street 1:101 OAK BEND DR
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6722
Practice Address - Country:US
Practice Address - Phone:267-516-7506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider