Provider Demographics
NPI:1790889327
Name:GOLAY, KATHRYN LLEWELLYN (ARNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LLEWELLYN
Last Name:GOLAY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:LLEWELLYN
Other - Last Name:GANNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:10410 RIDGEFIELD PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-3500
Mailing Address - Country:US
Mailing Address - Phone:804-754-3776
Mailing Address - Fax:804-754-0880
Practice Address - Street 1:10410 RIDGEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233
Practice Address - Country:US
Practice Address - Phone:804-754-3776
Practice Address - Fax:804-754-0880
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169787363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics