Healthcare Provider Details

I. General information

NPI: 1245049865
Provider Name (Legal Business Name): KATHERYN DANIELLE CARO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERYN DANIELLE MILLER

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E. HIRST ROAD, SUITE 200
PURCELLVILLE VA
20132-6199
US

IV. Provider business mailing address

224-D CORNWALL STREET, NW, SUITE 403
LEESBURG VA
20176-2704
US

V. Phone/Fax

Practice location:
  • Phone: 540-338-6101
  • Fax:
Mailing address:
  • Phone: 703-737-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110011557
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: