Healthcare Provider Details

I. General information

NPI: 1710606397
Provider Name (Legal Business Name): CAROLINE M MATTHEWS AG-ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLINE M HOZZA

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MEDICAL PKWY STE 212
CHESAPEAKE VA
23320-4985
US

IV. Provider business mailing address

667 KINGSBOROUGH SQ STE 101
CHESAPEAKE VA
23320-4999
US

V. Phone/Fax

Practice location:
  • Phone: 757-312-5292
  • Fax: 757-609-3225
Mailing address:
  • Phone: 757-842-4481
  • Fax: 757-312-3135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0024184932
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024184932
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: