Individual
KELLY GAIL BARRIAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
109 WIMBLEDON SQ, STE. E, CHESAPEAKE, VA 23320-4945
(757) 547-9830
(757) 548-0721
Mailing address
1035 CHAMPIONS WAY, STE 100, SUFFOLK, VA 23435-3762
(757) 394-1540
(757) 967-0793
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110002088
VA
363AM0700X
Medical Physician Assistant
Primary
0110002088
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164492138
—
VA
Enumeration date
01/24/2006
Last updated
05/28/2025
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