Individual
KAIE MANOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
211 GIBSON STREET, NW, SUITE 215, LEESBURG, VA 20176-2115
(571) 707-2085
Mailing address
224-D CORNWALL STREET, NW, STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024192734
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629875752
—
VA
05
—
30018220280001
—
VA
Enumeration date
02/26/2025
Last updated
05/26/2025
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