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General NPI Number Information
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NPI Number | 1558679845
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Entity Type | Individual
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Provider Name | DEBORAH ANN KERNOHAN NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/20/2010
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Last Update Date | 11/20/2019
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Provider Practice Location Address
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Address Line | 1530 S MAIN ST
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City | FARMVILLE
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State | VA
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Zip | 23901-2546
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Country | US
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Telephone | 434-315-2890
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Fax | 434-392-0333
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Provider Business Mailing Address
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Address Line | 1530 S MAIN ST
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City | FARMVILLE
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State | VA
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Zip | 23901-2546
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Country | US
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Telephone | 434-315-2890
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Fax | 434-392-0333
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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 | 11704-NP
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN 191533 COA-1
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0024172598
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License Number State | VA
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