Provider Demographics
NPI:1871229237
Name:CATANIA, AUDRA MARIA (APRN)
Entity type:Individual
Prefix:
First Name:AUDRA
Middle Name:MARIA
Last Name:CATANIA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 WOOD CHASE LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06471-1053
Mailing Address - Country:US
Mailing Address - Phone:203-641-4451
Mailing Address - Fax:
Practice Address - Street 1:2 DEVINE ST
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-2142
Practice Address - Country:US
Practice Address - Phone:203-747-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10938363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner