Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 0101046636 | VA |
NPI | 1023092608 |
---|---|
Provider Name | Kathryn K Stout |
First Address | Richmond, VA 23226-3754 |
Second Address | Kilmarnock, VA 22482-3843 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 11/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023092608 | (05) | VA |
F22909 | (02) | VA |