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NPI Code Detail

MEDICARE: KATHY ROSSER TIERNEY LNP,CNS

MEDICARE: KATHY ROSSER TIERNEY LNP,CNS
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
1146N00000XBasic Emergency Medical TechnicianB091304106VA
2163WP0809XAdult Psychiatric/Mental Health Registered Nurse0001078773VA
3363LP0808XPsychiatric/Mental Health Nurse Practitioner0024165434VA
4364SP0809XAdult Psychiatric/Mental Health Clinical Nurse Specialist0015000150VA

Other Identifiers

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

General Provider Information

NPI Number : 1780787895
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHY ROSSER TIERNEY LNP,CNS
Provider Business Mailing Address
First Line : 107 S 5TH ST
Second Line :
City : RICHMOND
State : VA
Zip : 23219-3825
Country : US
Telephone Number : 804-819-4236
Fax Number : 804-819-4266
Provider Business Practice Location Address
First Line : 107 S 5TH ST
Second Line :
City : RICHMOND
State : VA
Zip : 23219-3825
Country : US
Telephone Number : 804-819-4236
Fax Number : 804-819-4266
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2006
Last Update Date : 06/03/2008

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