Individual
CATHERINE A DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 E MADISON AVE STE 400A, MANKATO, MN 56001-6805
(507) 625-1811
Mailing address
PO BOX 8674, 1230 E MAIN ST MANKATO CLINIC LTD, MANKATO, MN 56002-8674
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
37871
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0965525
MEDICAID
IA
01
—
1202256
MEDICA
MN
01
—
121155
UCARE
MN
05
—
144719000
—
MN
01
—
370005354
RR MEDICARE
—
01
—
410849339 56001 C101
CHAMPUS
—
01
—
658425
AMERICAS PPO
MN
01
—
7K350DA
BCBS
MN
01
—
HP25201
HEALTH PARTNERS
MN
01
—
NA2951023823
PREFERRED ONE
MN
Enumeration date
01/10/2006
Last updated
07/10/2020
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