Healthcare Provider Details

I. General information

NPI: 1841069572
Provider Name (Legal Business Name): CATHERINE BANTON SNELLINGS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 MAPLE AVE STE 200
RICHMOND VA
23226-2553
US

IV. Provider business mailing address

1501 MAPLE AVE STE 200
RICHMOND VA
23226-2553
US

V. Phone/Fax

Practice location:
  • Phone: 804-285-2300
  • Fax:
Mailing address:
  • Phone: 804-285-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110010224
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: