Provider Demographics
NPI:1386276848
Name:MCPETERS, CAITLYN (MPAS)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:MCPETERS
Suffix:
Gender:F
Credentials:MPAS
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Other - First Name:
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Mailing Address - Street 1:1115 BOULDERS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:
Practice Address - Street 1:13801 ST FRANCIS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3206
Practice Address - Country:US
Practice Address - Phone:804-379-2414
Practice Address - Fax:804-379-2413
Is Sole Proprietor?:No
Enumeration Date:2020-02-12
Last Update Date:2020-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110-007063363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant