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General NPI Number Information
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NPI Number | 1770835993
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Entity Type | Individual
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Provider Name | CATHERINE A GRODEN NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 10301 NEW GUINEA RD TARGET
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City | FAIRFAX
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State | VA
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Zip | 22032
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Country | US
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Telephone | 703-764-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 1593 N COLONIAL TER 405
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City | ARLINGTON
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State | VA
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Zip | 22209-1430
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Country | US
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Telephone | 571-242-5253
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024168092
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC000668
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License Number State | MD
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