Healthcare Provider Details

I. General information

NPI: 1063859213
Provider Name (Legal Business Name): KIMBERLY BROOK NAPOLITANO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 05/28/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 NORTHSIDE FORSYTH DR
CUMMING GA
30041-7659
US

IV. Provider business mailing address

1200 NORTHSIDE FORSYTH DR
CUMMING GA
30041-7659
US

V. Phone/Fax

Practice location:
  • Phone: 404-851-8917
  • Fax: 404-303-3636
Mailing address:
  • Phone: 404-851-8917
  • Fax: 404-303-3636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberC002964
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN334856
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberC002964
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: