| Doctor Name: | KIMBERLY MOORE WESLEY |
| NPI Number: | 1144262379 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP |
| License Number: | 304185 |
| Business Practice Address: | 2 Coulter Rd Clifton Springs, NY - 144321122 |
| Business Phone Number: | 5859221900 |
| Business Fax Number: | 5859221002 |
| Mailing Address: | 4 Coulter Rd, CLIFTON SPRINGS |
| State: | NY |
| Postal Code: | 144321122 |
| Phone Number: | 3154629478 |
| Fax Number: | 3154626707 |
| NPI Enumeration Date: | 06/12/2006 |
| NPI Last Update Date: | 08/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 304185 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |