Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 0024177776 | VA |
NPI | 1073169348 |
---|---|
Provider Name | Katherine Chandler Quicke |
First Address | Richmond, VA 23235-1979 |
Second Address | Richmond, VA 23235-1979 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2019 |
Last Update Date | 28/10/2020 |