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General NPI Number Information
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NPI Number | 1477343044
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Entity Type | Individual
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Provider Name | MARY CATHERINE PRICKETT AG-ACNP-BC
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Gender |
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 1 AUTUMN CT
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City | MADISON
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State | VA
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Zip | 22727-3028
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Country | US
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Telephone | 540-948-3054
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Fax |
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Provider Business Mailing Address
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Address Line | 1912 LYNDHURST RD
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City | WAYNESBORO
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State | VA
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Zip | 22980-5225
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Country | US
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Telephone | 214-336-5768
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024188932
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License Number State | VA
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