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General NPI Number Information
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NPI Number | 1053038190
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Entity Type | Individual
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Provider Name | KIMBERLY ANN PATEL AG-ACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 1901 TATE SPRINGS RD
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City | LYNCHBURG
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State | VA
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Zip | 24501-1109
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Country | US
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Telephone | 636-357-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 202 WHITLEY WAY
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City | LYNCHBURG
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State | VA
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Zip | 24503-2154
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Country | US
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Telephone | 636-357-1050
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024183856
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License Number State | VA
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