Healthcare Provider Details

I. General information

NPI: 1952386047
Provider Name (Legal Business Name): KIMBERLY SUE NESBITT CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 SW 1ST AVE
OCALA FL
34474-4000
US

IV. Provider business mailing address

8078 NW 2ND ST
OCALA FL
34482-3810
US

V. Phone/Fax

Practice location:
  • Phone: 352-401-1000
  • Fax: 352-873-9726
Mailing address:
  • Phone: 352-873-8249
  • Fax: 352-873-8249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9200762
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: