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General NPI Number Information
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NPI Number | 1659444925
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Entity Type | Organization
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Legal Business Name | KIMBERLY L RAY PLLC
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 2409 HIGHWAY 70 E SUITE 4 OR 5
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City | DICKSON
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State | TN
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Zip | 37055-6126
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Country | US
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Telephone | 615-740-7322
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Fax | 615-740-7304
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Provider Business Mailing Address
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Address Line | 2409 HIGHWAY 70 E SUITE 4 OR 5
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City | DICKSON
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State | TN
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Zip | 37055-6126
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Country | US
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Telephone | 615-740-7322
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Fax | 615-740-7304
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY L RAY
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Credential | NP
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Telephone | 615-740-7322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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