Individual
KATHERINE GRUBBS DIEFENDERFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7001 FOREST AVE, SUITE 100, RICHMOND, VA 23230-1726
(804) 288-0808
(804) 288-8887
Mailing address
7001 FOREST AVE, SUITE 100, RICHMOND, VA 23230-1726
(804) 288-0808
(804) 288-8887
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024166667
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010207100
—
VA
01
—
C09462
GROUP PTAN
VA
Enumeration date
10/25/2006
Last updated
11/02/2012
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