Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 0024167108 | VA |
NPI | 1023200250 |
---|---|
Provider Name | Mrs. Catherine Cole Elder |
First Address | Springfield, VA 22152-1209 |
Second Address | Herndon, VA 20171-3413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2007 |
Last Update Date | 14/01/2012 |