Doctor Name: | KIMBERLY CAVILL |
NPI Number: | 1417229956 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 81731 |
Business Practice Address: | 341 Homewood Dr Charles Town, WV - 254145162 |
Business Phone Number: | 3042747356 |
Business Fax Number: | |
Mailing Address: | 341 Homewood Dr, CHARLES TOWN |
State: | WV |
Postal Code: | 254145162 |
Phone Number: | 3042747356 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2012 |
NPI Last Update Date: | 01/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 81731 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |