Provider Demographics
NPI:1043054521
Name:MAUNZ, KAYLEE (NP)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:MAUNZ
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:7202 GLEN FOREST DR STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3780
Mailing Address - Country:US
Mailing Address - Phone:804-673-2024
Mailing Address - Fax:804-673-1796
Practice Address - Street 1:1401 JOHNSTON WILLIS DR STE 100
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4730
Practice Address - Country:US
Practice Address - Phone:804-330-7990
Practice Address - Fax:804-330-2701
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-10-22
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Provider Licenses
StateLicense IDTaxonomies
VA0024191580363LA2200X
VA0001292107163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse