Basic Information
Provider Information | |||||||||
NPI: | 1952727216 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | MULLER | ||||||||
FirstName: | CATHERINE | ||||||||
MiddleName: | MICHELLE | ||||||||
NamePrefix: | MS. | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 388 | ||||||||
Address2: |   | ||||||||
City: | FISHERSVILLE | ||||||||
State: | VA | ||||||||
PostalCode: | 229390388 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5403325270 | ||||||||
FaxNumber: | 5403324168 | ||||||||
Practice Location | |||||||||
Address1: | 57 N MEDICAL PARK DR | ||||||||
Address2: |   | ||||||||
City: | FISHERSVILLE | ||||||||
State: | VA | ||||||||
PostalCode: | 229392353 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5403325270 | ||||||||
FaxNumber: | 5403324168 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/11/2014 | ||||||||
LastUpdateDate: | 07/30/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 07/30/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 0024171818 | VA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.