Individual
LARA ANN MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
325 CHARLES H DIMMOCK PKWY, COLONIAL HEIGHTS, VA 23834-2986
(804) 526-5888
Mailing address
11517 ROLLING BROOK RD, CHESTER, VA 23831-2032
(804) 514-1006
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1257944
VA
363LF0000X
Family Nurse Practitioner
Primary
24179891
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
N/A
—
Enumeration date
06/11/2021
Last updated
06/11/2021
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