Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 0101840551 | VA |
NPI | 1295937407 |
---|---|
Provider Name | Dr. Katherine Ann Laybourn |
First Address | Richmond, VA 23220-3506 |
Second Address | Petersburg, VA 23804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 08/07/2007 |