Doctor Name: | KIMBERLEY K PRIVETT |
NPI Number: | 1720337967 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NURSE PRACTITIONER |
License Number: | 3007601 |
Business Practice Address: | 732 Elizaville Ave Flemingsburg, KY - 410411139 |
Business Phone Number: | 6068492323 |
Business Fax Number: | 6068492025 |
Mailing Address: | 732 Elizaville Ave, P.o. Box 344 FLEMINGSBURG |
State: | KY |
Postal Code: | 410411139 |
Phone Number: | 6068492323 |
Fax Number: | 6068492025 |
NPI Enumeration Date: | 09/04/2012 |
NPI Last Update Date: | 01/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 3007601 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |