Healthcare Provider Details

I. General information

NPI: 1538309687
Provider Name (Legal Business Name): KATJA S AUSTIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4906 RADFORD AVE
RICHMOND VA
23230-3512
US

IV. Provider business mailing address

4906 RADFORD AVE
RICHMOND VA
23230-3512
US

V. Phone/Fax

Practice location:
  • Phone: 804-354-1996
  • Fax: 856-780-5153
Mailing address:
  • Phone: 804-354-1996
  • Fax: 856-780-1535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10036540
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP-990129
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP.AP.70127714-NP
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10036540
License Number StateOR
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0990129
License Number StateCO
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number181628
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: