Individual
KAREN ENNEKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
10978 BUCKLEY HALL ROAD, MATHEWS, VA 23109
(047) 253-0418
(804) 725-3510
Mailing address
PO BOX 327, MATHEWS, VA 23109-0327
(757) 725-3041
(804) 725-3510
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
0024176017
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024176017
VA
Other
Enumeration date
08/15/2018
Last updated
02/08/2024
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