Provider Demographics
NPI:1497389654
Name:MCDANIEL-NAGARI, KIMLA KAYE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KIMLA
Middle Name:KAYE
Last Name:MCDANIEL-NAGARI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:VA
Mailing Address - Zip Code:24127-7546
Mailing Address - Country:US
Mailing Address - Phone:601-876-8408
Mailing Address - Fax:
Practice Address - Street 1:417 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:VA
Practice Address - Zip Code:24127-7546
Practice Address - Country:US
Practice Address - Phone:601-876-8408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001291281163WD1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal