Individual
KIM RAE GUASTELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM,ARNP
Contact information
Practice address
19465 DEERFIELD AVE, SUITE 205, LEESBURG, VA 20176-1701
(703) 726-1300
(703) 726-9612
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
0024168019
VA
367A00000X
Advanced Practice Midwife
ARNP9319862
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013152784
—
FL
05
—
1013152784
—
VA
Enumeration date
12/10/2008
Last updated
09/26/2013
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