Healthcare Provider Details

I. General information

NPI: 1700237781
Provider Name (Legal Business Name): CATHERINE OBINNA DNP, ARNP, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2016
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 BROAD ROCK BLVD
RICHMOND VA
23249-2376
US

IV. Provider business mailing address

1013 CONNECTICUT AVE
GLEN ALLEN VA
23060-2376
US

V. Phone/Fax

Practice location:
  • Phone: 804-475-3754
  • Fax:
Mailing address:
  • Phone: 804-475-3754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number0024172914
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: