Provider Demographics
NPI:1245320167
Name:EUBANKS, CATHY DAWN (CRNP)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:DAWN
Last Name:EUBANKS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 WILLOW BEACH RD APT B5
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-2224
Mailing Address - Country:US
Mailing Address - Phone:256-558-6568
Mailing Address - Fax:256-582-6376
Practice Address - Street 1:1241 BLOUNT AVE
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-1831
Practice Address - Country:US
Practice Address - Phone:256-582-6377
Practice Address - Fax:256-582-6377
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-073520363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily