Provider Demographics
NPI:1366058232
Name:WHICHARD, CARAH GRACE (PA-C)
Entity type:Individual
Prefix:
First Name:CARAH
Middle Name:GRACE
Last Name:WHICHARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:18778 GRAHAMS DR
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-7096
Mailing Address - Country:US
Mailing Address - Phone:276-698-5437
Mailing Address - Fax:
Practice Address - Street 1:229 CLEARFIELD AVE STE 300
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1815
Practice Address - Country:US
Practice Address - Phone:757-457-5100
Practice Address - Fax:757-961-3696
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110007784363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant