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General NPI Number Information
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NPI Number | 1144812546
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Entity Type | Individual
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Provider Name | COLLEEN ANN KUPESKY CNS
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Gender | Female
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Dates
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Enumeration Date | 02/07/2021
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Last Update Date | 02/07/2021
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Provider Practice Location Address
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Address Line | 2466 ACADEMY RD
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City | POWHATAN
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State | VA
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Zip | 23139-5820
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Country | US
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Telephone | 804-399-9037
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Fax |
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Provider Business Mailing Address
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Address Line | 2466 ACADEMY RD
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City | POWHATAN
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State | VA
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Zip | 23139-5820
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Country | US
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Telephone | 804-399-9037
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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 | 364SA2100X
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Taxonomy Name | Acute Care Clinical Nurse Specialist
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License Number | 0015001099
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001165805
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License Number State | VA
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