MEDICARE: ANALEASE KNUCKLES CAUTHORNE

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024195331	VA

General Provider Information

NPI Number	:	1164392536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANALEASE KNUCKLES CAUTHORNE

Provider Business Mailing Address
First Line	:	7700 E PARHAM RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23294-4301
Country	:	US
Telephone Number	:	804-606-0268
Fax Number	:

Provider Business Practice Location Address
First Line	:	7700 E PARHAM RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23294-4301
Country	:	US
Telephone Number	:	804-606-0268
Fax Number	:

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

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	06/01/2026

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