Healthcare Provider Details

I. General information

NPI: 1124836671
Provider Name (Legal Business Name): CATHERINE HALL OBRIEN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 FIRST COLONIAL RD STE 30
VIRGINIA BEACH VA
23454-2409
US

IV. Provider business mailing address

1101 FIRST COLONIAL RD STE 30
VIRGINIA BEACH VA
23454-2409
US

V. Phone/Fax

Practice location:
  • Phone: 757-395-1760
  • Fax:
Mailing address:
  • Phone: 757-395-1760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110011168
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: