Provider Demographics
NPI:1912333600
Name:KINGSFORD, KATHERINE A (RN)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:A
Last Name:KINGSFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:401 CARPENTER RD BLDG 525
Mailing Address - Street 2:ANDREW RADER US ARMY HEALTH CLINIC
Mailing Address - City:FORT MYER
Mailing Address - State:VA
Mailing Address - Zip Code:22211-1009
Mailing Address - Country:US
Mailing Address - Phone:703-696-7950
Mailing Address - Fax:703-696-0103
Practice Address - Street 1:401 CARPENTER RD BLDG 525
Practice Address - Street 2:ANDREW RADER US ARMY HEALTH CLINIC
Practice Address - City:FORT MYER
Practice Address - State:VA
Practice Address - Zip Code:22211-1009
Practice Address - Country:US
Practice Address - Phone:703-696-7950
Practice Address - Fax:703-696-0103
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0001071202163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVAD000Medicare UPIN