Individual
MS. CAITLYN TAYLOR PRIMAVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3021 LYNNHAVEN DR, VIRGINIA BEACH, VA 23451-1112
(850) 896-7207
Mailing address
3021 LYNNHAVEN DR, VIRGINIA BEACH, VA 23451-1112
(850) 896-7207
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110009756
VA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/05/2022
Last updated
04/11/2024
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