Healthcare Provider Details

I. General information

NPI: 1124680392
Provider Name (Legal Business Name): CAITLIN MICHELLE WEILBAECHER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 E PARHAM RD STE 102
RICHMOND VA
23228-2234
US

IV. Provider business mailing address

2703 COACHOUSE LN
HENRICO VA
23233-2149
US

V. Phone/Fax

Practice location:
  • Phone: 504-228-0960
  • Fax:
Mailing address:
  • Phone: 504-349-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024182206
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024182206
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: