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Individual

CAROLE KATHLEEN FUNK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
841 N SHENANDOAH AVE STE 3, FRONT ROYAL, VA 22630-3501
(540) 636-7000
Mailing address
841 N SHENANDOAH AVE STE 3, FRONT ROYAL, VA 22630-3501
(540) 636-7000
(540) 636-7029

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024170414
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0024170414
VA LICENSE
VA
Enumeration date
10/11/2012
Last updated
07/18/2024
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