Provider Demographics
NPI:1568502946
Name:KIRKPATRICK, KRISTINE (NP)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26139 LANDS END DR
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-2542
Mailing Address - Country:US
Mailing Address - Phone:703-895-3618
Mailing Address - Fax:703-542-7070
Practice Address - Street 1:6400 ARLINGTON BLVD
Practice Address - Street 2:SUITE 940
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042
Practice Address - Country:US
Practice Address - Phone:703-241-1010
Practice Address - Fax:703-542-7070
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166537363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1143644OtherRN LICENSE
VA0024166537OtherNP LICENSE