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Individual

KIMBERLY ODEL BURNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
9184 BUCKLEY HALL RD, MATHEWS, VA 23109-2309
(804) 725-0100
(804) 414-7529
Mailing address
11301 KIMAGES RD, CHARLES CITY, VA 23030-2736
(518) 527-0938

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
335613
NY
363LF0000X
Family Nurse Practitioner
Primary
0024178960
VA
363LF0000X
Family Nurse Practitioner
SP010330
PA

Other

Enumeration date
04/13/2010
Last updated
05/07/2025
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