Provider Demographics
NPI:1285296111
Name:TARNAI, KIMBERLY STEWART (PA-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:STEWART
Last Name:TARNAI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1138
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-1138
Mailing Address - Country:US
Mailing Address - Phone:540-688-2646
Mailing Address - Fax:
Practice Address - Street 1:25 MYERS CORNER DR
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-6342
Practice Address - Country:US
Practice Address - Phone:804-241-3867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-006716363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical