Healthcare Provider Details

I. General information

NPI: 1457562571
Provider Name (Legal Business Name): KIMBERLY A DULANEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 E MAIN ST
FLOYD VA
24091-4183
US

IV. Provider business mailing address

2145 MOUNT PLEASANT BLVD SE
ROANOKE VA
24014-3632
US

V. Phone/Fax

Practice location:
  • Phone: 540-745-2031
  • Fax:
Mailing address:
  • Phone: 540-427-9200
  • Fax: 540-427-3237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101242182
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: