| Doctor Name: | KIMBERLY HADLEY |
| NPI Number: | 1619108768 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | 10845 |
| Business Practice Address: | 7909 Highway N Dardenne Prairie, MO - 633687382 |
| Business Phone Number: | 6366251560 |
| Business Fax Number: | |
| Mailing Address: | 10460 Anzeiger Ave, FRONTENAC |
| State: | MO |
| Postal Code: | 631312753 |
| Phone Number: | 6417810168 |
| Fax Number: | |
| NPI Enumeration Date: | 08/06/2009 |
| NPI Last Update Date: | 08/31/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 10845 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |