Provider Demographics
NPI:1770212573
Name:NARDELLI, ANNA KILEEN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:KILEEN
Last Name:NARDELLI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LAUREL DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-2907
Mailing Address - Country:US
Mailing Address - Phone:401-309-8598
Mailing Address - Fax:
Practice Address - Street 1:1015 W 47TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508
Practice Address - Country:US
Practice Address - Phone:757-683-7041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist