Provider Demographics
NPI:1477794709
Name:HAHN, KIMBERLY E (FNP)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:E
Last Name:HAHN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:KIMBERLY
Other - Middle Name:E
Other - Last Name:HAHN RUDOLPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:136 LINDEN DR STE 104
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6900
Mailing Address - Country:US
Mailing Address - Phone:540-678-3588
Mailing Address - Fax:540-678-9025
Practice Address - Street 1:152 LINDEN DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2818
Practice Address - Country:US
Practice Address - Phone:540-667-9252
Practice Address - Fax:540-722-4514
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV69024363LF0000X
VA0024175359363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily