Provider Demographics
NPI:1235901570
Name:MURTHA, CAITLYN MARIE
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:MARIE
Last Name:MURTHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5930 WHITEHURST LN UNIT B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-5608
Mailing Address - Country:US
Mailing Address - Phone:757-848-7870
Mailing Address - Fax:
Practice Address - Street 1:5930 WHITEHURST LN UNIT B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-5608
Practice Address - Country:US
Practice Address - Phone:757-848-7870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant