Provider Demographics
NPI:1710606397
Name:MATTHEWS, CAROLINE M (AG-ACNP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:M
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:AG-ACNP
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:M
Other - Last Name:HOZZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:667 KINGSBOROUGH SQ STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4999
Mailing Address - Country:US
Mailing Address - Phone:757-842-4481
Mailing Address - Fax:757-312-3135
Practice Address - Street 1:300 MEDICAL PKWY STE 212
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4985
Practice Address - Country:US
Practice Address - Phone:757-312-5292
Practice Address - Fax:757-609-3225
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA00241849322084N0400X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024184932OtherVA NP LICENSE