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Individual

KIMBERLY MARY SPAN

Active
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Individual

KIMBERLY MARY SPAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101246307
VA
208M00000X
Hospitalist Physician
0101246307
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
-028
TRICARE/CHAMPUS
VA
01
10071693
SENTARA/OPTIMA HEALTH
VA
01
1336302454
FIRST HEALTH NETWORK/COVENTRY HEALTH
VA
05
1336302454
VA
01
422982
ANTHEM BC/BS
VA
05
5916953
NC
01
PAR
VIRGINIA HEALTH NETWORK
VA
Enumeration date
07/09/2008
Last updated
10/30/2024
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