Provider Demographics
NPI:1962002717
Name:CARREY, CAYLEE CARIN (CPNP)
Entity Type:Individual
Prefix:
First Name:CAYLEE
Middle Name:CARIN
Last Name:CARREY
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:CAYLEE
Other - Middle Name:CARIN
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:9900 INDEPENDENCE PARK DR., STE 100
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233
Mailing Address - Country:US
Mailing Address - Phone:804-747-1750
Mailing Address - Fax:
Practice Address - Street 1:9900 INDEPENDENCE PARK DR., STE 100
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233
Practice Address - Country:US
Practice Address - Phone:804-747-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA202017222208000000X
VA0024117949363L00000X
VA0024-179491363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner