Organization
HAMPTON ROADS PATH TO WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DENESE MCKISSACK (NP)
(615) 569-1661
Entity
Organization
Contact information
Practice address
367 MANNING LN, HAMPTON, VA 23666-5024
(757) 405-6060
Mailing address
367 MANNING LN, HAMPTON, VA 23666-5024
(615) 569-1661
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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