Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 0024173712 | VA |
NPI | 1033561378 |
---|---|
Provider Name | Mrs. Catherine Marie Staats |
First Address | Stephens City, VA 22655-2920 |
Second Address | Stephens City, VA 22655-2920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2016 |
Last Update Date | 11/07/2016 |