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Organization
KIDNEY CARE INTEGRATED SERVICES, LLC
Active
Organization
KIDNEY CARE INTEGRATED SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA J PALMER (ASSISTANT SECRETARY AND CLO)
(202) 236-7061
Entity
Organization
Contact information
Practice address
1861 INTERNATIONAL DR STE 600, MC LEAN, VA 22102-4420
(571) 992-0600
Mailing address
1861 INTERNATIONAL DR STE 600, MC LEAN, VA 22102-4420
(571) 992-0600
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/27/2023
Last updated
02/27/2023
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