Provider Demographics
NPI:1194905653
Name:BARTHOLOMAY, KATHERINE BAYLOR (FNP-BC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:BAYLOR
Last Name:BARTHOLOMAY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 UNIVERSITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2503
Mailing Address - Country:US
Mailing Address - Phone:703-383-8130
Mailing Address - Fax:703-383-7353
Practice Address - Street 1:3801 UNIVERSITY DR STE 300
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2503
Practice Address - Country:US
Practice Address - Phone:703-383-8130
Practice Address - Fax:703-383-7353
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017138926363LF0000X, 163WX0601X
VA0024167498363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0601XNursing Service ProvidersRegistered NurseOtorhinolaryngology & Head-Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1194905653OtherNPI