Kevin Witty, R.N.
Individual provider Active NPI Child & Adolescent Psychiatric/Mental Health Registered Nurse · Kenbridge, VA
NPI 1821428699 · NPPES record last updated Nov 15, 2013
Key facts
- NPI
- 1821428699
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X
- License
- 1993451570 (VA)
- Practice address
- 231 Hickory Rd
Kenbridge, VA 23944-3503 - Phone
- (434) 676-1375
- Fax
- (434) 676-1391
- NPI assigned
- Nov 15, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1993451570 | VA | MD | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MBHS of Kenbridge, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatric/Mental Health Registered Nurse | 163WP0807X | 1993451570 | VA | Yes |
Addresses
Primary practice location
231 Hickory Rd
Kenbridge, VA 23944-3503
Mailing address
231 Hickory Rd
Kenbridge, VA 23944-3503
Phone (434) 676-1375
Other providers in Kenbridge, VA
- Smiths Pharmacy & Home Health Care Center of Kenbridge Inc
- Southside Medical Management
- Southside Medical Management Inc
- Three Rivers Treatment Center LLC
- William Irby Jr DDS PC
- Cristyl Hawthorne Word
All providers in Kenbridge, VA · Child & Adolescent Psychiatric/Mental Health Registered Nurse in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.