Provider Demographics
NPI:1952352114
Name:KIMMER-LYNCH, BARBARA J (FNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:KIMMER-LYNCH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 DIGGES RD STE 104
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4414
Mailing Address - Country:US
Mailing Address - Phone:703-973-9007
Mailing Address - Fax:540-364-6245
Practice Address - Street 1:9001 DIGGES RD STE 104
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4414
Practice Address - Country:US
Practice Address - Phone:703-973-9007
Practice Address - Fax:540-364-6245
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024000067363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010205549Medicaid
VA010205484Medicaid
VA010205476Medicaid
VA010205557Medicaid
VA008647N42Medicare ID - Type Unspecified
VA010205549Medicaid
VA010205484Medicaid