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General NPI Number Information
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NPI Number | 1013066620
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Entity Type | Individual
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Provider Name | KIMBERLY ANN KOVACICH NP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1010 BORDEN RD
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City | RICHMOND
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State | VA
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Zip | 23229-6716
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Country | US
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Telephone | 833-767-4386
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Fax | 833-874-0554
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Provider Business Mailing Address
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Address Line | 1010 BORDEN RD
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City | RICHMOND
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State | VA
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Zip | 23229-6716
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Country | US
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Telephone | 833-767-4386
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Fax | 833-874-0554
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0024191129
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71000468A
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License Number State | IN
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