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NPI Code Detail

MEDICARE: MISS KIMBERLY MCCUE FNP-BC, DNP

MEDICARE: MISS KIMBERLY MCCUE FNP-BC, DNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0024170174VA

General Provider Information

NPI Number : 1558356808
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KIMBERLY MCCUE FNP-BC, DNP
Provider Business Mailing Address
First Line : 3259 CATLIN AVE
Second Line :
City : QUANTICO
State : VA
Zip : 22134-5109
Country : US
Telephone Number : 703-784-1640
Fax Number :
Provider Business Practice Location Address
First Line : 3259 CATLIN AVE
Second Line :
City : QUANTICO
State : VA
Zip : 22134-5109
Country : US
Telephone Number : 703-784-1640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 03/27/2024

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