Healthcare Provider Details

I. General information

NPI: 1215003777
Provider Name (Legal Business Name): ROBIN SANDY CATHER PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 03/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2913 VALLEY AVE SUITE 200
WINCHESTER VA
22601-2676
US

IV. Provider business mailing address

PO BOX 221 88RED GATE ROAD
MILLWOOD VA
22646-0221
US

V. Phone/Fax

Practice location:
  • Phone: 540-678-0792
  • Fax: 540-678-0795
Mailing address:
  • Phone: 540-837-1066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024107329
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: