Provider Demographics
NPI:1215015904
Name:APOLLONY CAPPUZZO, KIMBERLY ANN (PHARMD, MS)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANN
Last Name:APOLLONY CAPPUZZO
Suffix:
Gender:F
Credentials:PHARMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4816 SOUTHERNESS WAY
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE FORGE
Mailing Address - State:VA
Mailing Address - Zip Code:23140-4430
Mailing Address - Country:US
Mailing Address - Phone:804-828-3252
Mailing Address - Fax:804-828-8359
Practice Address - Street 1:410 N 12TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5062
Practice Address - Country:US
Practice Address - Phone:804-828-3252
Practice Address - Fax:804-828-8359
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022053001835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric