Provider Demographics
NPI:1093484446
Name:VESS, KYLIE (BSN, RN)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:VESS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5999 BURKE COMMONS RD FL BURKEVA4
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2880
Mailing Address - Country:US
Mailing Address - Phone:202-430-2829
Mailing Address - Fax:
Practice Address - Street 1:5999 BURKE COMMONS RD FL BURKEVA4
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-2880
Practice Address - Country:US
Practice Address - Phone:202-430-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001293142163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse