Healthcare Provider Details

I. General information

NPI: 1659698256
Provider Name (Legal Business Name): KIMBERLY GAY JAMES CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 SUNSET LN
COLUMBIA MO
65203-2253
US

IV. Provider business mailing address

1114 SUNSET LN
COLUMBIA MO
65203-2253
US

V. Phone/Fax

Practice location:
  • Phone: 573-424-9115
  • Fax:
Mailing address:
  • Phone: 573-424-9115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: