Individual
KENYALE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 HILL TOP DR, RICHMOND, VA 23225-4457
(804) 283-0076
Mailing address
1000 HILL TOP DR, RICHMOND, VA 23225-4457
(804) 283-0076
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
0002087989
VA
172A00000X
Driver
Primary
T64205998
VA
Other
Enumeration date
08/01/2022
Last updated
08/01/2022
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