Provider Demographics
NPI:1023200250
Name:ELDER, CATHERINE COLE (NP)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:COLE
Last Name:ELDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:MAY COLE
Other - Last Name:PALMINTIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6010 GREELEY BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1209
Mailing Address - Country:US
Mailing Address - Phone:703-644-9779
Mailing Address - Fax:
Practice Address - Street 1:13525 DULLES TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-3413
Practice Address - Country:US
Practice Address - Phone:703-481-8160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-12
Last Update Date:2012-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167108363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health