Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 0024171925 | VA |
NPI | 1033518741 |
---|---|
Provider Name | Kristin L. Phipps |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22908-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2014 |
Last Update Date | 15/03/2016 |