Provider Demographics
NPI:1346980026
Name:BETCHER, KAITLYN ANN (PA)
Entity Type:Individual
Prefix:MS
First Name:KAITLYN
Middle Name:ANN
Last Name:BETCHER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:KAITLYN
Other - Middle Name:ANN
Other - Last Name:BETCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:1880 AMHERST STREET
Mailing Address - Street 2:SUITE 100 AND SUITE 200
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601
Mailing Address - Country:US
Mailing Address - Phone:540-662-0306
Mailing Address - Fax:855-264-2066
Practice Address - Street 1:1880 AMHERST STREET
Practice Address - Street 2:SUITE 100 AND SUITE 200
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2873
Practice Address - Country:US
Practice Address - Phone:540-662-0306
Practice Address - Fax:855-264-2066
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-008439363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical