Healthcare Provider Details
I. General information
NPI: 1437227832
Provider Name (Legal Business Name): KATHRYN PASSE CATHCART P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/01/2006
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
590 PETER JEFFERSON PKWY STE 100
CHARLOTTESVILLE VA
22911-4628
US
IV. Provider business mailing address
PO BOX 746550
ATLANTA GA
30374-6550
US
V. Phone/Fax
- Phone: 434-654-8930
- Fax: 434-654-8931
- Phone: 888-236-2263
- Fax: 434-654-8931
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | MA52862 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 0110003675 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: