Provider Demographics
NPI:1528109683
Name:CATES, ELIZABETH (MA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CATES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 N CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-2336
Mailing Address - Country:US
Mailing Address - Phone:712-792-1432
Mailing Address - Fax:
Practice Address - Street 1:821 N CARROLL ST
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-2336
Practice Address - Country:US
Practice Address - Phone:712-792-1432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA54396440172A00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered172A00000XOther Service ProvidersDriver
Not Answered251E00000XAgenciesHome Health