Wittenbrook, Kelly Ann

Wittenbrook, Kelly Ann is an individual health care provider with primary practice located at 3000 Coliseum Dr Fl 2 , Hampton VA 23666-5963. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Wittenbrook, Kelly Ann can be contacted via phone (757) 736-1347.

Contact Information

Primary practice address
3000 Coliseum Dr Fl 2 Hampton VA 23666-5963
Phone: (757) 736-1347
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X APRN.CNP.0037515 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 306145 New York
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X APN.29631 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 0024172480 Virginia

Profile Details

NPI number 1073868519
LBN Legal business name Wittenbrook, Kelly Ann
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2012
Last updated Feb 13th, 2025 - about last year

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 1073868519 NPPES
New York MEDICAID 01406284

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