Provider Demographics
NPI:1790587178
Name:MCCAFFREY- LEYDEN, KAITLIN MARIE
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:MARIE
Last Name:MCCAFFREY- LEYDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CAPESIDE CT
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-1149
Mailing Address - Country:US
Mailing Address - Phone:443-880-8452
Mailing Address - Fax:
Practice Address - Street 1:732 THIMBLE SHOALS BLVD STE 203
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4262
Practice Address - Country:US
Practice Address - Phone:757-873-8566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024193055363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health