Basic Information
| Provider Information | |||||||||
| NPI: | 1962573618 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARRISON | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | MAGUIRE | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 676 DEKALB PIKE | ||||||||
| Address2: | STE 104 | ||||||||
| City: | BLUE BELL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194221223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154566940 | ||||||||
| FaxNumber: | 2154551933 | ||||||||
| Practice Location | |||||||||
| Address1: | 50 TOWNSHIP LINE RD | ||||||||
| Address2: | MEDICAL ARTS BLDG, SUITE G01 | ||||||||
| City: | ELKINS PARK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190272249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155725200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2006 | ||||||||
| LastUpdateDate: | 01/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | SP008601 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363L00000X | SP008601 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.