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Organization

KPNP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHLEEN M PACK NP (AUTHORIZED OFFICIAL/OWNER)
(804) 617-0687
Entity
Organization

Contact information

Practice address
8353 DUSTY LN, MECHANICSVILLE, VA 23116-2406
(804) 617-0687
(804) 282-9135
Mailing address
8353 DUSTY LN, MECHANICSVILLE, VA 23116-2406
(804) 617-0687
(804) 282-9135

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Enumeration date
09/25/2019
Last updated
09/25/2019
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