Individual
KIRSTEN N PENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4092 FOXWOOD DR., STE 101, VA BEACH, VA 23462-5225
(757) 467-4200
(757) 686-0541
Mailing address
P.O. BOX 7549, PORTSMOUTH, VA 23707-0549
(757) 686-3525
(757) 686-0541
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101245787
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116018438
VA
Other
Enumeration date
06/19/2008
Last updated
02/23/2015
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