Provider Demographics
NPI:1942742382
Name:OTWY, CAT (RN)
Entity type:Individual
Prefix:
First Name:CAT
Middle Name:
Last Name:OTWY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:ANNETTE
Other - Last Name:OTWAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:2940 BRUSHPOPPER LN
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-9621
Mailing Address - Country:US
Mailing Address - Phone:406-214-4109
Mailing Address - Fax:
Practice Address - Street 1:500 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4008
Practice Address - Country:US
Practice Address - Phone:406-329-5776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT33174163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse