Individual
KATHLEEN M PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
8266 ATLEE RD, SUITE 230, MECHANICSVILLE, VA 23116-1804
(804) 730-0792
(804) 746-7699
Mailing address
PO BOX 11768, RICHMOND, VA 23230-0168
(804) 330-4000
(804) 213-9783
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024166085
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010257239
—
VA
Enumeration date
07/02/2006
Last updated
06/06/2024
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