Individual
MEGAN CATHERINE KISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19415 DEERFIELD AVE, SUITE 213, LEESBURG, VA 20176-8470
(703) 729-9220
(703) 858-3529
Mailing address
224D CORNWALL ST NW STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110007168
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467017137
—
VA
05
—
30016138230001
—
VA
Enumeration date
05/07/2019
Last updated
02/08/2024
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