MEDICARE: MS. KIMBERLY BROWN FARMER PA-C

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	363AM0700X	Medical Physician Assistant	101831	NC
2	363A00000X	Physician Assistant	101831	NC
3	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851395198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY BROWN FARMER PA-C

Provider Business Mailing Address
First Line	:	CVS MINUTE CLINIC
Second Line	:	6901 MARKET ST
City	:	WILMINGTON
State	:	NC
Zip	:	28411
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

Provider Business Practice Location Address
First Line	:	CVS MINUTE CLINIC
Second Line	:	6901 MARKET ST
City	:	WILMINGTON
State	:	NC
Zip	:	28411
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	10/27/2020

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