Provider Demographics
NPI:1861171860
Name:FALLS, KATHERINE HENDRICK (NP)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:HENDRICK
Last Name:FALLS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 LOGAN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-3463
Mailing Address - Country:US
Mailing Address - Phone:804-304-8522
Mailing Address - Fax:
Practice Address - Street 1:2809 NORTH AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-3647
Practice Address - Country:US
Practice Address - Phone:804-780-0840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024102-179363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health