Kloosterboer, Shelby

Kloosterboer, Shelby is an individual health care provider with primary practice located at 46440 Benedict Drive, Suite 107 , Sterling VA 20164-6602. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Kloosterboer, Shelby can be contacted via phone (703) 450-1125.

Contact Information

Primary practice address
46440 Benedict Drive, Suite 107 Sterling VA 20164-6602
Phone: (703) 450-1125
Fax: (703) 450-1145
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110007652 Virginia

Profile Details

NPI number 1679105530
LBN Legal business name Kloosterboer, Shelby
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 10th, 2020
Last updated Mar 7th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679105530 NPPES
Virginia MEDICAID 30016389950001
Virginia MEDICAID 1679105530

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