Provider Demographics
NPI:1346946779
Name:ROADCAP, KAITLIN SHEA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:SHEA
Last Name:ROADCAP
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 THOROFARE RD
Mailing Address - Street 2:
Mailing Address - City:CRIMORA
Mailing Address - State:VA
Mailing Address - Zip Code:24431-2412
Mailing Address - Country:US
Mailing Address - Phone:540-241-9938
Mailing Address - Fax:
Practice Address - Street 1:54 S MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2333
Practice Address - Country:US
Practice Address - Phone:540-886-2956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024186441363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily