Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 0024171808 | VA |
NPI | 1043626229 |
---|---|
Provider Name | Erin Kegelman |
First Address | Richmond, VA 23220-5334 |
Second Address | Richmond, VA 23298-5051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2014 |
Last Update Date | 08/07/2014 |