=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699517011
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAYLEE NICOLE WARRENFELTZ PA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/07/2024
-----------------------------------------------------
Last Update Date | 02/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2006 HEALTH CAMPUS DR STE 300
-----------------------------------------------------
City | ROCKINGHAM
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22801-8679
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-689-5400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1775 N SECTOR CT STE 200
-----------------------------------------------------
City | WINCHESTER
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22601-2859
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-552-9585
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------