Doctor Name: | MRS. KIMBERLY THIGPEN EVANS |
NPI Number: | 1043591076 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | RN113548 |
Business Practice Address: | 621 East First Street, Unit B Vidalia, GA - 30474 |
Business Phone Number: | 4782748739 |
Business Fax Number: | |
Mailing Address: | 621 East First Street, Unit B, VIDALIA |
State: | GA |
Postal Code: | 30474 |
Phone Number: | 9125377476 |
Fax Number: | 9125388443 |
NPI Enumeration Date: | 09/03/2011 |
NPI Last Update Date: | 09/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN113548 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |