Provider Demographics
NPI:1215177142
Name:PRITCHARD, KIMBERLY ANNE (PHD, ATC)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:ANNE
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:PHD, ATC
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:ANNE
Other - Last Name:RUPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:1460 UNIVERSITY DR
Mailing Address - Street 2:DIVISION OF ATHLETIC TRAINING
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-5100
Mailing Address - Country:US
Mailing Address - Phone:540-545-7376
Mailing Address - Fax:
Practice Address - Street 1:1460 UNIVERSITY DR
Practice Address - Street 2:DIVISION OF ATHLETIC TRAINING
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-5100
Practice Address - Country:US
Practice Address - Phone:540-454-7376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260012802255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer