Provider Demographics
NPI:1992172779
Name:ABSTON, CATHY DENISE (NP-C)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:DENISE
Last Name:ABSTON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2497 S ROANE ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-8670
Mailing Address - Country:US
Mailing Address - Phone:865-647-3570
Mailing Address - Fax:865-647-3579
Practice Address - Street 1:2497 S ROANE ST
Practice Address - Street 2:SUITE 110
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-8670
Practice Address - Country:US
Practice Address - Phone:865-647-3570
Practice Address - Fax:865-647-3579
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20390363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ018521Medicaid
TNQ018521Medicaid