MEDICARE: MS. CAITLIN MICHELLE WEILBAECHER FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024182206	VA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024182206	VA

General Provider Information

NPI Number	:	1124680392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAITLIN MICHELLE WEILBAECHER FNP

Provider Business Mailing Address
First Line	:	2703 COACHOUSE LN
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23233-2149
Country	:	US
Telephone Number	:	504-349-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 E PARHAM RD STE 102
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-2234
Country	:	US
Telephone Number	:	504-228-0960
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2019
Last Update Date	:	09/25/2025

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