Healthcare Provider Details

I. General information

NPI: 1093845026
Provider Name (Legal Business Name): KIMBERLY N JONES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY AKERS

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 BELLAIRE DR
NICHOLASVILLE KY
40356
US

IV. Provider business mailing address

204 BELLAIRE DR
NICHOLASVILLE KY
40356-8840
US

V. Phone/Fax

Practice location:
  • Phone: 859-887-4882
  • Fax: 859-881-1728
Mailing address:
  • Phone: 859-887-4882
  • Fax: 859-881-1728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1005
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA1005
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: