Provider Demographics
NPI:1417191826
Name:DONLON, KIMBERLY (NNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:DONLON
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13702 BEECHWOOD POINT RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2529
Mailing Address - Country:US
Mailing Address - Phone:804-639-1904
Mailing Address - Fax:
Practice Address - Street 1:13702 BEECHWOOD POINT RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2529
Practice Address - Country:US
Practice Address - Phone:804-639-1904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024102823363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care