Healthcare Provider Details

I. General information

NPI: 1326624586
Provider Name (Legal Business Name): KATHERINE M MCCAULEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 M ST NW FL 5
WASHINGTON DC
20037-1597
US

IV. Provider business mailing address

2300 M ST NW FL 5
WASHINGTON DC
20037-1597
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-3300
  • Fax:
Mailing address:
  • Phone: 202-741-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: