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General NPI Number Information
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NPI Number | 1245670116
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Entity Type | Individual
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Provider Name | KIMBERLY MICHELLE CARR NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/25/2013
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Last Update Date | 09/12/2017
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Provider Practice Location Address
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Address Line | 710 N MAIN ST
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City | SPRINGBORO
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State | OH
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Zip | 45066-8944
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Country | US
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Telephone | 937-748-1135
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Fax |
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Provider Business Mailing Address
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Address Line | 4387 LEEDS POINT CT APT 279
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City | WEST CHESTER
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State | OH
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Zip | 45069-8769
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Country | US
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Telephone | 678-520-4851
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F0613462
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 18494
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License Number State | OH
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