Guastella, Kim Rae

Guastella, Kim Rae is an individual health care provider with primary practice located at 19465 Deerfield Ave Suite 205, Leesburg VA 20176-1701. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Midwife, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Other Service Providers / Midwife is her primary health care specialty. Guastella, Kim Rae can be contacted via phone (703) 726-1300.

Contact Information

Primary practice address
19465 Deerfield Ave Suite 205 Leesburg VA 20176-1701
Phone: (703) 726-1300
Fax: (703) 726-9612
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Midwife 176B00000X 0024168019 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X ARNP9319862 Florida

Profile Details

NPI number 1013152784
LBN Legal business name Guastella, Kim Rae
Credentials CNM,ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 10th, 2008
Last updated Sep 26th, 2013 - about 12 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 1013152784 NPPES
Florida MEDICAID 1013152784
Florida MEDICAID 1013152784

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