MEDICARE: MRS. KIMBERLY ANNE MCLAUGHLIN CLD, CCCE

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	374J00000X	Doula

General Provider Information

NPI Number	:	1396075172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY ANNE MCLAUGHLIN CLD, CCCE

Provider Business Mailing Address
First Line	:	812 BLACK ROCK CIR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37934-5078
Country	:	US
Telephone Number	:	865-705-7734
Fax Number	:

Provider Business Practice Location Address
First Line	:	812 BLACK ROCK CIR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37934-5078
Country	:	US
Telephone Number	:	865-705-7734
Fax Number	:

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

Provider Enumeration Date	:	12/30/2009
Last Update Date	:	12/30/2009

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