Provider Demographics
NPI:1477868867
Name:ANDERSON, CATHERINE B (NP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:B
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 STAPLES MILL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-2942
Mailing Address - Country:US
Mailing Address - Phone:804-281-0451
Mailing Address - Fax:804-281-0954
Practice Address - Street 1:2235 STAPLES MILL RD STE 100
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-2942
Practice Address - Country:US
Practice Address - Phone:804-281-0451
Practice Address - Fax:804-281-0954
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168879363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC01120OtherMEDICARE GROUP PTAN
VAVVD150AMedicare PIN