Healthcare Provider Details

I. General information

NPI: 1982163598
Provider Name (Legal Business Name): KIMBERLY WOOD ELGIN DNP, RN, ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 07/22/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 LEE ST
CHARLOTTESVILLE VA
22908-0816
US

IV. Provider business mailing address

1866 RHETT CT
CHARLOTTESVILLE VA
22903-8805
US

V. Phone/Fax

Practice location:
  • Phone: 434-982-0950
  • Fax:
Mailing address:
  • Phone: 434-982-0950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number0024181834
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: