Provider Demographics
NPI:1366528002
Name:DOUGLAS, CATHERINE D (MS, RNC)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:D
Last Name:DOUGLAS
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Gender:F
Credentials:MS, RNC
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Mailing Address - Street 1:7130 GLEN FOREST DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3754
Mailing Address - Country:US
Mailing Address - Phone:804-288-4084
Mailing Address - Fax:804-282-8678
Practice Address - Street 1:12129 GRAHAM MEADOWS DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-6661
Practice Address - Country:US
Practice Address - Phone:804-288-4084
Practice Address - Fax:804-282-2601
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2018-04-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024167142363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1366528002Medicaid
VA1366528002Medicaid