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General NPI Number Information
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NPI Number | 1659300598
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Entity Type | Individual
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Provider Name | KATHLEEN M PACK F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 8266 ATLEE RD SUITE 230
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-1804
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Country | US
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Telephone | 804-730-0792
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Fax | 804-746-7699
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Provider Business Mailing Address
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Address Line | PO BOX 11768
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City | RICHMOND
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State | VA
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Zip | 23230-0168
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Country | US
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Telephone | 804-330-4000
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Fax | 804-213-9783
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024166085
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License Number State | VA
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