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General NPI Number Information
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NPI Number | 1538552443
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Entity Type | Organization
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Legal Business Name | KIMBERLY WEBB LLC
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Dates
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Enumeration Date | 03/17/2015
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Last Update Date | 03/17/2015
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Provider Practice Location Address
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Address Line | 1303 RIGGS CHAPEL RD
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City | HARRIMAN
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State | TN
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Zip | 37748-7364
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Country | US
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Telephone | 865-755-2496
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Fax |
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Provider Business Mailing Address
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Address Line | 1303 RIGGS CHAPEL RD
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City | HARRIMAN
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State | TN
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Zip | 37748-7364
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Country | US
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Telephone | 865-755-2496
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER--FNP
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Name | KIMBERLY ELAINE WEBB
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Credential | FNP
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Telephone | 865-755-2496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 19686
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License Number State | TN
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