Provider Demographics
NPI:1306653274
Name:CANIGLIA, KELLY LYNN (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:LYNN
Last Name:CANIGLIA
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 RIVERVIEW RD
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23161-4017
Mailing Address - Country:US
Mailing Address - Phone:207-956-2252
Mailing Address - Fax:
Practice Address - Street 1:2611 THOMAS JEFFERSON PKWY
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:VA
Practice Address - Zip Code:22963-5000
Practice Address - Country:US
Practice Address - Phone:434-423-4311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024192084363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty