Healthcare Provider Details

I. General information

NPI: 1477293991
Provider Name (Legal Business Name): EIFA CATHERINE WILLARD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EIFA CATHERINE SANDO

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 E HUNDRED RD
CHESTER VA
23836-2613
US

IV. Provider business mailing address

PO BOX 780125
PHILADELPHIA PA
19178-0125
US

V. Phone/Fax

Practice location:
  • Phone: 804-530-1172
  • Fax:
Mailing address:
  • Phone: 804-922-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024184292
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024184292
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: