Organization
NEW KENT PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY BRADY (AUTHORIZED OFFICIAL)
(757) 784-5808
Entity
Organization
Contact information
Practice address
7410 COOPER TAVERN RD STE B, QUINTON, VA 23141-2257
(804) 223-3608
(804) 223-3648
Mailing address
PO BOX 8310, ROANOKE, VA 24014-0310
(540) 345-3556
(540) 342-2193
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/07/2019
Last updated
07/16/2020
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