Provider Demographics
NPI:1841186129
Name:RIEWE, KYNDAL KAY (PA-C)
Entity type:Individual
Prefix:
First Name:KYNDAL
Middle Name:KAY
Last Name:RIEWE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6026 78TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-1702
Mailing Address - Country:US
Mailing Address - Phone:806-543-0504
Mailing Address - Fax:
Practice Address - Street 1:501 SUNSET LN
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3917
Practice Address - Country:US
Practice Address - Phone:540-829-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110011016363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant