Healthcare Provider Details

I. General information

NPI: 1114888377
Provider Name (Legal Business Name): KATHERINE VISCONTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE VISCONTI PHARMD

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 STAPLES MILL RD
RICHMOND VA
23228-2021
US

IV. Provider business mailing address

8344 CHARING LN
GLEN ALLEN VA
23059-5389
US

V. Phone/Fax

Practice location:
  • Phone: 804-977-9515
  • Fax:
Mailing address:
  • Phone: 804-855-4155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202223172
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: