Provider Demographics
NPI:1154891372
Name:MELIAGROS, CAITLIN MCMANUS (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MCMANUS
Last Name:MELIAGROS
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12929 HOLMBANK LN
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7693
Mailing Address - Country:US
Mailing Address - Phone:703-509-6841
Mailing Address - Fax:
Practice Address - Street 1:204 N HAMILTON ST STE B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-2662
Practice Address - Country:US
Practice Address - Phone:804-353-1230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-30
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176401363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care