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NPI Code Detail

MEDICARE: MS. KIMBERLY ANNE LEFTWICH RN, MSN-FNP

MEDICARE: MS. KIMBERLY ANNE LEFTWICH RN, MSN-FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse0001160613VA
2363LF0000XFamily Nurse Practitioner0024166238VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194709311
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIMBERLY ANNE LEFTWICH RN, MSN-FNP
Provider Business Mailing Address
First Line : PO BOX 470
Second Line :
City : CHARLOTTE COURT HOUSE
State : VA
Zip : 23923-0470
Country : US
Telephone Number : 434-542-5560
Fax Number :
Provider Business Practice Location Address
First Line : 165 LEGRANDE AVE
Second Line :
City : CHARLOTTE COURT HOUSE
State : VA
Zip : 23923-3747
Country : US
Telephone Number : 434-542-5560
Fax Number : 434-542-5745
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2005
Last Update Date : 09/07/2016

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