Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 0024180352 | VA |
NPI | 1174122535 |
---|---|
Provider Name | Kristen Marie Atkins |
First Address | Chesapeake, VA 23320-2931 |
Second Address | Norfolk, VA 23507-1971 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2020 |
Last Update Date | 18/10/2020 |