Individual
MISS KASHA DENNA FADOUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
135 HALL AVE, SUFFOLK, VA 23434-4657
(757) 514-4700
Mailing address
135 HALL AVE, SUFFOLK, VA 23434-4657
(757) 514-4700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001276705
VA
163W00000X
Registered Nurse
81858
WV
363L00000X
Nurse Practitioner
Primary
0024175624
VA
363LF0000X
Family Nurse Practitioner
APRN81858-FNP-BC
WV
Other
Enumeration date
11/01/2016
Last updated
04/11/2018
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