Provider Demographics
NPI:1144294166
Name:CATHEY, CECILIA ANN (FNP)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:ANN
Last Name:CATHEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CECILIA
Other - Middle Name:ANN
Other - Last Name:CAMPION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 31ST AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2345
Mailing Address - Country:US
Mailing Address - Phone:320-252-6680
Mailing Address - Fax:
Practice Address - Street 1:333 WASHINGTON AVE N
Practice Address - Street 2:# 5000
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55401-1377
Practice Address - Country:US
Practice Address - Phone:612-659-7111
Practice Address - Fax:612-659-7101
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR067840-3363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q55114Medicare UPIN
MN500003180Medicare PIN