KIMBERLY MCKISSACK NP NPI 1720490386

NPI Information

  • NPI: 1720490386
  • Provider Name: KIMBERLY MCKISSACK, NP
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • Address: 100 EMANCIPATION DR
    HAMPTON, VA
    ZIP 23667
  • Phone: (757) 722-9961

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NPI Details

Kimberly Mckissack, NP is a primary care nurse practitioner in Hampton, VA. Kimberly Mckissack, NP NPI is 1720490386. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

100 EMANCIPATION DR
HAMPTON, VA
ZIP 23667-302
Phone: (757) 722-9961

The enumeration date for this NPI number is 5/29/2014 and was last updated on 8/20/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary Care0024173116VIRGINIAYes
2363L00000XNurse Practitioner0024173116VIRGINIANo
3363LW0102XNurse PractitionerWomen's HealthAPN0000018429TENNESSEENo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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