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Individual

MRS. CHELSEA KIDD KADAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8700 SUDLEY RD, MANASSAS, VA 20110-4418
(703) 396-5292
(703) 396-5297
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(703) 396-5292
(703) 396-5297

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
0001229048
VA
363L00000X
Nurse Practitioner
Primary
0024177043
NC

Other

Enumeration date
10/04/2018
Last updated
10/26/2020
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