Provider Demographics
NPI:1114215449
Name:SAPRE, KIMBERLY (DMSC, PA-C, CAQ-EM)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:SAPRE
Suffix:
Gender:F
Credentials:DMSC, PA-C, CAQ-EM
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:HOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3310 WESSYNTON WAY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-2229
Mailing Address - Country:US
Mailing Address - Phone:540-848-0108
Mailing Address - Fax:
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3300
Practice Address - Country:US
Practice Address - Phone:703-776-2334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2023-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110003625363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical