Provider Demographics
NPI:1801837802
Name:OPRANDI, KATHRYN L (PA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:L
Last Name:OPRANDI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:L
Other - Last Name:OPRANDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1115 BOULDERS PKWY
Mailing Address - Street 2:STE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:15564 WESTCHESTER COMMONS WAY
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-7321
Practice Address - Country:US
Practice Address - Phone:804-440-4878
Practice Address - Fax:804-423-2451
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001331363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00140759OtherRAILROAD MEDICARE
VA010105153Medicaid
VA010105153Medicaid
004664F01Medicare PIN