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NPI Code Detail

MEDICARE: KATHY M CAVANAUGH N.P.

MEDICARE:   KATHY M CAVANAUGH  N.P.
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
1363LF0000XFamily Nurse Practitioner0024164610VA

General Provider Information

NPI Number : 1528042199
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHY M CAVANAUGH N.P.
Provider Business Mailing Address
First Line : 1201 BROAD ROCK BLVD
Second Line :
City : RICHMOND
State : VA
Zip : 23249-0001
Country : US
Telephone Number : 804-675-5000
Fax Number :
Provider Business Practice Location Address
First Line : 1202 BROAD ROCK BLVD
Second Line :
City : RICHMOND
State : VA
Zip : 23249-1010
Country : US
Telephone Number : 804-675-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2005
Last Update Date : 05/19/2025

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Directions to “ KATHY M CAVANAUGH N.P.” Practice Location

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