Individual
KATY HUGHES FEDORKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 EMANCIPATION DR, HAMPTON, VA 23667-2906
(757) 722-9961
Mailing address
1614 COUGAR AVE, NORFOLK, VA 23518-2906
(757) 374-8861
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110007314
VA
Other
Enumeration date
04/18/2020
Last updated
07/03/2020
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