Healthcare Provider Details

I. General information

NPI: 1366473613
Provider Name (Legal Business Name): KAREN KIMM RAMSDELL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN LEE KIMM PA

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 CONNECTICUT AVE NW STE 1250
WASHINGTON DC
20036-1728
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6631
  • Fax:
Mailing address:
  • Phone: 843-789-1620
  • Fax: 843-724-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number785
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA200001580
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: