Healthcare Provider Details

I. General information

NPI: 1619520939
Provider Name (Legal Business Name): KIMBERLY L OWNBY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 07/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 LUCY DR
HARRISONBURG VA
22801-8036
US

IV. Provider business mailing address

240 LUCY DR
HARRISONBURG VA
22801-8036
US

V. Phone/Fax

Practice location:
  • Phone: 540-438-1314
  • Fax:
Mailing address:
  • Phone: 540-438-1314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0024177745
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: