MEDICARE: KIMBERLY ATKINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LSW0000006027	TN

General Provider Information

NPI Number	:	1225558984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY ATKINS

Provider Business Mailing Address
First Line	:	1005 TILLMAN ST STE 217
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38112-2038
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 TILLMAN ST STE 217
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38112-2038
Country	:	US
Telephone Number	:	901-380-2042
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2017
Last Update Date	:	06/30/2017

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Directions to “ KIMBERLY ATKINS ” Practice Location

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