Individual
KELSEY GINESTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
19415 DEERFIELD AVENUE, SUITE 314, LEESBURG, VA 20176-8427
(703) 723-7171
(703) 723-7176
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-3346
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110008371
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164091260
—
VA
05
—
30017440810001
—
VA
Enumeration date
06/22/2021
Last updated
10/31/2023
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