Provider Demographics
NPI:1487729448
Name:KAHLER, KATHRYN A (FNP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:KAHLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:A
Other - Last Name:KIPPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:434-295-1000
Mailing Address - Fax:434-972-4266
Practice Address - Street 1:24 GLOUCESTER RD
Practice Address - Street 2:
Practice Address - City:STUARTS DRAFT
Practice Address - State:VA
Practice Address - Zip Code:24477-3321
Practice Address - Country:US
Practice Address - Phone:540-337-3710
Practice Address - Fax:540-337-0930
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165288363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1487729448Medicaid
WVWV0486AMedicare PIN