Individual
KIMBERLEE ALISSA FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2790 GODWIN BLVD STE 360, SUFFOLK, VA 23434-8153
(757) 934-4821
(757) 934-4276
Mailing address
2790 GODWIN BLVD STE 360, SUFFOLK, VA 23434-8153
(757) 934-4821
(757) 934-4276
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024189017
VA
363LA2100X
Acute Care Nurse Practitioner
RN294676
GA
363LG0600X
Gerontology Nurse Practitioner
RN294676
GA
Other
Enumeration date
01/15/2024
Last updated
08/12/2024
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