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General NPI Number Information
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NPI Number | 1972176071
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Entity Type | Individual
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Provider Name | KATHRYN ELIZABETH FUNK ACAGNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 1002 BON SECOURS DR
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City | SUFFOLK
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State | VA
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Zip | 23435
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Country | US
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Telephone | 757-541-1110
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Fax | 757-541-1119
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Provider Business Mailing Address
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Address Line | PO BOX 639971
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City | CINCINNATI
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State | OH
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Zip | 45263-9971
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Country | US
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Telephone |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0024182240
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License Number State | VA
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