Lara Elaine Kiser, FNP-BC

Individual provider Active NPI Family Nurse Practitioner · Cedar Bluff, VA

NPI 1487057568 · NPPES record last updated Oct 2, 2014

Key facts

NPI
1487057568
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
0024172068 (VA)
Practice address
216 College Ridge Road
Cedar Bluff, VA 24609-0765
Phone
(276) 964-7176
Fax
(276) 964-7157
NPI assigned
Oct 2, 2014
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160719000040 VA Practitioner - Nurse Practitioner 0941505598 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Agency for Senior Citizens Current
since Jun 1, 2016
Accepting new patients
Appalachian Agency for Senior Citizens, Inc Past
since Jun 1, 2016
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024172068 VA Yes

Addresses

Primary practice location

216 College Ridge Road
Cedar Bluff, VA 24609-0765

Mailing address

PO Box 765
Cedar Bluff, VA 24609-0765
Phone (276) 964-7176

Other providers in Cedar Bluff, VA

All providers in Cedar Bluff, VA · Family Nurse Practitioner in Virginia

Sources for this page

Verify at the official NPI Registry.