Provider Demographics
NPI:1659472454
Name:KENNEY, KIMBRA (MD)
Entity Type:Individual
Prefix:
First Name:KIMBRA
Middle Name:
Last Name:KENNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6605 LEE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-1923
Mailing Address - Country:US
Mailing Address - Phone:703-532-4110
Mailing Address - Fax:
Practice Address - Street 1:WALTER REED ARMY MEDICAL CENTER, ATTN: MCHL-MAO-C
Practice Address - Street 2:6900 GEORGIA AVENUE, N.W.
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-5001
Practice Address - Country:US
Practice Address - Phone:202-782-3321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010527552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology