Provider Demographics
NPI:1770576878
Name:KIESSLING, BRENDA ROBIN (MD)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:ROBIN
Last Name:KIESSLING
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10610 HUNTERS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22181-3018
Mailing Address - Country:US
Mailing Address - Phone:703-938-9389
Mailing Address - Fax:703-460-9359
Practice Address - Street 1:2900 TELESTAR CT
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1206
Practice Address - Country:US
Practice Address - Phone:703-396-6197
Practice Address - Fax:703-779-1372
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2010-07-06
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Provider Licenses
StateLicense IDTaxonomies
VA101037093207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5699088Medicaid
VA5699088Medicaid
VA013690P02Medicare ID - Type UnspecifiedMETRO DC MEDICARE