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Individual

KIMBERLY SOUTUYO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2722 MERRILEE DR, SUITE 230, FAIRFAX, VA 22031-4420
(703) 698-4444
(703) 204-0116
Mailing address
2722 MERRILEE DR, SUITE 230, FAIRFAX, VA 22031-4420
(703) 698-4444
(703) 204-0116

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024172024
VA

Other

Enumeration date
10/27/2014
Last updated
10/27/2014
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