Individual
LOGAN PETE KINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 GRESHAM DR, NORFOLK, VA 23507-1904
(757) 388-3000
Mailing address
134 BUSINESS PARK DR, VIRGINIA BEACH, VA 23462-6523
(757) 473-0044
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101277901
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390200000X
—
NC
Enumeration date
03/19/2019
Last updated
09/25/2025
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