Basic Information
Provider Information
NPI: 1538247796
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PREEDY
FirstName: CATHERINE
MiddleName: A
NamePrefix: MS.
NameSuffix:  
Credential: APN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P.O. BOX 191
Address2: NEMOURS CHILDRENS CLINIC
City: ROCKLAND
State: DE
PostalCode: 197320191
CountryCode: US
TelephoneNumber: 9046974201
FaxNumber: 3026514945
Practice Location
Address1: 1600 ROCKLAND RD
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198033607
CountryCode: US
TelephoneNumber: 3026514200
FaxNumber: 3026515460
Other Information
ProviderEnumerationDate: 11/02/2006
LastUpdateDate: 10/09/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LN0000XVP004178JPAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
363LN0005XL10025391DEN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
363LP0200XLM0000120DEY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
363LP0200XL10025391DEN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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