Individual
JOSEPHINE PANGAN BOLIVAR-KERNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9299 TOWER SIDE DR APT 438, FAIRFAX, VA 22031-6032
(414) 939-6346
Mailing address
9299 TOWER SIDE DR APT 438, FAIRFAX, VA 22031-6032
(414) 939-6346
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024183581
VA
Other
Enumeration date
02/06/2022
Last updated
07/26/2022
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