Individual
KIMBERLY BROOKE FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-03823
NC
363A00000X
Physician Assistant
0110003169
VA
363A00000X
Physician Assistant
488
WV
363AM0700X
Medical Physician Assistant
0110-002169
VA
363AM0700X
Medical Physician Assistant
Primary
0110-003169
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326370438
—
VA
Enumeration date
02/01/2010
Last updated
02/27/2024
Update your record
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