Provider Demographics
NPI:1548248578
Name:PINKHAM, CATHERINE JO (CNA)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:JO
Last Name:PINKHAM
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:MRS
Other - First Name:CATHERINE
Other - Middle Name:JO
Other - Last Name:PINKHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNA
Mailing Address - Street 1:329 SWEDEN RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04009-3523
Mailing Address - Country:US
Mailing Address - Phone:207-647-4096
Mailing Address - Fax:
Practice Address - Street 1:329 SWEDEN RD
Practice Address - Street 2:
Practice Address - City:BRIDGTON
Practice Address - State:ME
Practice Address - Zip Code:04009-3523
Practice Address - Country:US
Practice Address - Phone:207-647-4096
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide