Healthcare Provider Details

I. General information

NPI: 1922325901
Provider Name (Legal Business Name): DARBRA WILLIS KIMBEL NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2706 OLD FORT PKWY SUITE E
MURFREESBORO TN
37128-4252
US

IV. Provider business mailing address

300 STONECREST BLVD SUITE 100
SMYRNA TN
37167-5688
US

V. Phone/Fax

Practice location:
  • Phone: 615-893-1230
  • Fax: 615-893-1232
Mailing address:
  • Phone: 615-223-9502
  • Fax: 615-223-9596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number14956
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: