Healthcare Provider Details

I. General information

NPI: 1083165146
Provider Name (Legal Business Name): KIMBERLY ANN DEVILBISS CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 06/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 AIRPORT BLVD
MOBILE AL
36608
US

IV. Provider business mailing address

PO BOX 7987
MOBILE AL
36670-0987
US

V. Phone/Fax

Practice location:
  • Phone: 251-633-0573
  • Fax: 251-633-7367
Mailing address:
  • Phone: 251-633-7211
  • Fax: 251-410-6079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number1-063802
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number1-063802
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number1-063802
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: