Healthcare Provider Details

I. General information

NPI: 1235764309
Provider Name (Legal Business Name): KIMBERLY ANN BAILEY DEXTER NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15361 BRADFORD RD
CULPEPER VA
22701-4238
US

IV. Provider business mailing address

15361 BRADFORD RD
CULPEPER VA
22701-4238
US

V. Phone/Fax

Practice location:
  • Phone: 540-825-5656
  • Fax:
Mailing address:
  • Phone: 540-540-8255
  • Fax: 540-825-6287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024179509
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number000123867
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: