MEDICARE: KRISTEN M HOLCK KOBULNICKY NP

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
1	363LA2100X	Acute Care Nurse Practitioner	0024169604	VA

General Provider Information

NPI Number	:	1942589437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN M HOLCK KOBULNICKY NP

Provider Business Mailing Address
First Line	:	PO BOX 780125
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-0125
Country	:	US
Telephone Number	:	804-922-4844
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 E MARSHALL ST
Second Line	:	ORTHOPAEDIC SURGERY
City	:	RICHMOND
State	:	VA
Zip	:	23298-5051
Country	:	US
Telephone Number	:	804-828-6611
Fax Number	:	804-828-6129

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2011
Last Update Date	:	02/09/2026

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