Individual
CATHERINE SHANNON DEZYNSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP, CNM
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
209.008431
IL
367A00000X
Advanced Practice Midwife
209-017470
IL
367A00000X
Advanced Practice Midwife
Primary
209071470
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400448067
MEDICARE
IL
Enumeration date
11/01/2010
Last updated
08/11/2021
Update your record
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