Provider Demographics
NPI:1346412145
Name:COLLURAFICI, KIMBERLY KAY (MSN APRN FNPC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:KAY
Last Name:COLLURAFICI
Suffix:
Gender:F
Credentials:MSN APRN FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 WIGGINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5188
Mailing Address - Country:US
Mailing Address - Phone:434-385-7578
Mailing Address - Fax:434-385-9756
Practice Address - Street 1:113 WIGGINGTON RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5188
Practice Address - Country:US
Practice Address - Phone:434-385-7578
Practice Address - Fax:434-385-9756
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167724363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily