Basic Information
| Provider Information | |||||||||
| NPI: | 1235451576 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANTHONY | ||||||||
| FirstName: | CATHY | ||||||||
| MiddleName: | CD | ||||||||
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| Credential: | RRT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 870294 | ||||||||
| Address2: | |||||||||
| City: | WASILLA | ||||||||
| State: | AK | ||||||||
| PostalCode: | 996870294 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9073577156 | ||||||||
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| Practice Location | |||||||||
| Address1: | 501 W INTERNATIONAL AIRPORT RD STE 1A | ||||||||
| Address2: | |||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995181106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075656100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2010 | ||||||||
| LastUpdateDate: | 02/26/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2279P3900X | I-2905 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Neonatal/Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 104387 | 01 | NC | NATIONAL BOARD FOR RESPIRATORY CARE | OTHER |