Individual
KIMBERLY T PREVOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24440 STONE SPRINGS BLVD, DULLES, VA 20166-2247
(703) 861-7660
Mailing address
25226 JUSTICE DR, SOUTH RIDING, VA 20152-6011
(703) 861-7660
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
0001222497
VA
Other
Enumeration date
10/26/2018
Last updated
10/26/2018
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